Ventalation Flashcards
Breathing and decreasing ICP
Hyperventilation
MOA:
Hyperventilation–> ↓ PCO2 –> vasoconstriction –> ↓ cerebral blood flow–> ↓ ICP
Noninvasive ventilation
positive pressure ventilation through a noninvasive interface: nasal mask, facemask, or nasal plugs
vs.
invasive interface (endotracheal tube, tracheostomy)
Criteria for Extubation from Mechanical Ventilation-
Spontaneous respiratory rate
< 33 breaths/min
Initial settings for Noninvasive ventilation
FiO2, Ins/ Expiratory pressure
FiO2 100%
Inspiratory= 8
Experitory= 4
titrate by 2
Criteria for Extubation from Mechanical Ventilation-
A-a gradient
< 300-500 mm Hg
Assist Control
ventilator delivers preset breaths in coordination with the respiratory effort of the patient
The RR set is the RR they get
Spontaneous breathing independent of the ventilator between A/C breaths is NOT allowed.
Criteria for Extubation from Mechanical Ventilation-
Po2 (on 40% Fio,) and Pco2
Po2 (on 40% Fio,) > 70 mm Hg
Pco2 < 45 mm Hg
Pressure support ventilation
Every time a pt initiates a breath, they get the pressure I set
Synchronous intermittent mandatory ventilation
Ventilator delivers preset breaths in coordination with the respiratory effort of the patient.
Spontaneous breathing is allowed between breaths
frequently the Ventilation mode of choice in patients whose respiratory failure is not severe and who have an adequate respiratory drive.
Pressure support ventilation
A respiratory rate (RR) of _________ breaths per minute is recommended for patients not requiring hyperventilation
8-12
FiO2 settings
The lowest FiO2 that produces:
Arterial oxygen saturation (SaO2) > 90%
PaO2> 60 mm Hg .
Determining Tidal Volume
Initial TV ~ 6 mL/kg of ideal body weight
goal is to adjust the TV so that plateau pressures are less than 35 cm H2O.
Plateau= no flow in ventilatory, measuring pressure in alveolus (measuring pulm compliance)
Minute Ventilation
Total volume of gas entering lungs per minute (VE)
VE = VT × RR
VT = 500 mL/breath
Primary variables that regulate PaO2
FiO2
PEEP- Better choice