Vent Review

Question 1

What are indications for mechanical ventilation in adults? (4)

Answer 1

1. Apnea
2. Acute Ventilatory Failure
3. Impending Ventilatory Failure
4. Severe refractory hypoxemia

Question 2

What are vital parameters would indicate signs of acute ventilator failure?

Answer 2

PaCO2 > 55 w/a pH < 7.25

Question 3

What are vital parameters would indicate signs of impending ventilator failure?

• hint what would MIP, VC, Vt, RR, and/or Vd/Vt be?

Answer 3

Assess WOB and patient condition; but the following parameters would be in the table:

• If time permits, split this slide into other flashcards

Question 4

What values would help indicate refractory hypoxemia and/or severity level of lung diseases?

Answer 4

1. A-a gradient
2. PF ratio
3. PaO2/PaO2

Question 5

What would lung protective strategies goals be for Vt?

Answer 5

Lung protective parameters for Vt would be 4-6 ml/kg (normal is 6-8)

Question 6

What are oxygenation goals for ARDS

Answer 6

PaO2 55-80 mmHg or SpO2 88-95%

• use w/minimum PEEP of 5
• Low PEEP/higher FiO2 or the inverse

Question 7

Steps to consider for a ventilated patient

Answer 7

1. Know the strategy (ABG targets/goals of ventilation and expected course)
2. Assess effectiveness of current ventilation
3. Support muscles of ventilation (correct balance of patient work vs. ventilator work/synchrony when possible)

Question 8

Adult TBI goals?

Answer 8

• pH: 7.40-7.45
• PaCO2: 35-40
• PaO2: 80-120

Question 9

Neonate pphn vent goals?

Answer 9

• pH: 7.40-7.45
• PaCO2: 35-40
• PaO2: >100

Question 10

Neonate cyanosis heart defect vent goals

Answer 10

Rule of 40s

• pH: 7.40
• PaCO2: 40
• PaO2: 40

Question 11

Meconium aspiration syndrome vent goals?

Answer 11

Avoid acidosis and hypoxemia