Test 2 Ch.5 Flashcards
A patient can be connected to positive pressure ventilator using either a
positive pressure mask or an artificial airway
what are used to administer NIV
Face and nasal mask
2 methods of providing noninvasive positive pressure ventilator support
- Continuous positive airway pressure (CPAP)
- Noninvasive positive pressure ventilation (NIV)
The ventilator provides the Energy necessary to maintain effective alveolar ventilation (high PEEP)
Full ventilatory support (FVS)
Full ventilatory support= adequate
vt for pt
Pt participates in the WOB (normal PEEP)
Partial ventilatory support( PVS)
Partially ventilatory support is any degrees of MV in which set machine rates are lower than
6 breaths/ min and the pts participates in WOB
Type of breath
- Mandatory breath
- Spontaneous
- Assisted
Ventilator controls the timing of tidal volume or inspiratory pressure
Mandatory breaths
Pt controls the timing and the tidal volume; based on pts demand and the pt’s lung characteristics
Spontaneous breaths
Has characteristics of both mandatory and spontaneous breaths
Assisted breaths
If the airway pressure rises above baseline during inspiration the breath is
assisted
All or part of the breath is
generated by the ventilator
Three types of breath delivery timing or sequence are available on current ICU ventilators:
- Continuous mandatory ventilation (CMV)
- Intermittent mandatory ventilation (IMV)
- Continuous spontaneous ventilation (CSV)
All breaths are mandatory and can be volume or pressure targeted; breaths can be timed or pt triggered
Continuous mandatory ventilation (CMV)
When the breaths are time triggered the breaths are described as
controlled ventilation (control mode)
When the breaths are pt triggered during CMV, the breaths are
assisted ventilation
Controlled (time- triggered) ventilation is appropriate only when a pt
cannot make an effort to breath
Pt receives a set number of mandatory breaths but can also breath spontaneously breaths between mandatory breath
Intermittent Mechanical Ventilation (IMV)
All breaths are spontaneous and pt triggered
Continuous spontaneous ventilation (CSV)
VC-CMV is also referred to as
volume- controlled continuous mandatory ventilation (targeted)
All breaths are _____________ in VC-CMV
mandatory
If the pt triggers the breath it is called
assisted
Once thought to minimize WOB DURING mv; Pt receiving this mode of ventilation may actually perform 33%- 50% or more of the work of inspiration
VC-CMV
All breaths are timed or pt triggered pressure targeted, time cycled. What kind of ventilation is this?
Pressure- Controlled Continuous Mandatory Ventilation (PC-CMV)
PC-CMV is also called
pressure- triggered or simply pressure controlled ventilation
With ____-______ the ventilator provides a constant pressure
PC-CMV
The maximum pressure limit during PC-CMV is typically set to approximately
+10 cm H2O
The operator sets the length of ___________ the pressure level and the back rate of ventilation
inspiration
The ____ is delivered by the ventilator is influenced by the ____________ and resistance of the pt’s lungs, pt effort and the set pressure
VT; compliance
The pt can breathe spontaneously between mandatory breaths at any desired baseline pressure w/o receiving a mandatory breath
Intermittent Mandatory Ventilation (IMV)
Involves periodic volume - or pressure targeted breaths that occur at set interval (Time triggering)
IMV
Three basic modes for providing CSV during MV
- Spontaneous breaths
- Continuous positive airway pressure (CPAP)
- Pressure support ventilation (PSV)
pts can breath spontaneously through a ventilator w/ receiving any mandatory breaths
Spontaneous modes
In this mode a continue level of positive pressure is applied to the pt’s airway through inspiration and expiration
Continuos positive airway pressure (CPAP)
CPAP is helpful for improving ___________ in pts w/ ______________ hypoxemia and low _____
oxygenation; refractory; FRC
The ventilator provides a constant pressure during inspiration once it senses that the pt has made an inspiratory effort; normal is 5
Pressure support ventilation (PSV)
Bilevel positive airway pressure (bilevel PAP) is also called
- biphasic positive airway pressure
- bill pressure assist
bilevel PAP is another form pressure ventilation often used in
NIV
Volume-triggered, pressure control breath
Pressure regulated volume control (PRVC)
Basically pressure support with a volume target
Volume support ventilation (VSV)
Is designed to provide high and low airway pressure levels when spontaneous effort is present
Airway Pressure Release Ventilation (APRV)
Mandatory Minute Ventilation is also called
- minimum minute ventilation
- augmented minute ventilation
Volume is constant pressure based on the
pt’s lung characteristics
Advantages of Volume being th controlled variable
- Gurantee a septic volume delivery and volume of expired gas
- can maintain a certain PaCO2
(allows for a bigger breath)
Disadvantages of Volume being th controlled variable
- Evident when lung conditions worsens
- High pressures
Pressure is set as the ______________ variable
independent
pressure controlled ventilation is not used
frequently
Considered a lung protective strategy
pressure controlled ventilation
Advantages of pressure controlled ventilation
- allows a set max pressure
- set pressure reduces the risk of over distention
Disadvantages of pressure controlled ventilation
- volume delivery varies w/ pt’s lung characteristics
- clinicians may be less familiar w/ pressure control ventilation
