Ventalation Flashcards

1
Q

Breathing and decreasing ICP

A

Hyperventilation

MOA:
Hyperventilation–> ↓ PCO2 –> vasoconstriction –> ↓ cerebral blood flow–> ↓ ICP

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2
Q

Noninvasive ventilation

A

positive pressure ventilation through a noninvasive interface: nasal mask, facemask, or nasal plugs

vs.

invasive interface (endotracheal tube, tracheostomy)

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3
Q

Criteria for Extubation from Mechanical Ventilation-

Spontaneous respiratory rate

A

< 33 breaths/min

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4
Q

Initial settings for Noninvasive ventilation

FiO2, Ins/ Expiratory pressure

A

FiO2 100%
Inspiratory= 8
Experitory= 4
titrate by 2

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5
Q

Criteria for Extubation from Mechanical Ventilation-

A-a gradient

A

< 300-500 mm Hg

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6
Q

Assist Control

A

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.

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7
Q

Criteria for Extubation from Mechanical Ventilation-

Po2 (on 40% Fio,) and Pco2

A

Po2 (on 40% Fio,) > 70 mm Hg

Pco2 < 45 mm Hg

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8
Q

Pressure support ventilation

A

Every time a pt initiates a breath, they get the pressure I set

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9
Q

Synchronous intermittent mandatory ventilation

A

Ventilator delivers preset breaths in coordination with the respiratory effort of the patient.
Spontaneous breathing is allowed between breaths

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10
Q

frequently the Ventilation mode of choice in patients whose respiratory failure is not severe and who have an adequate respiratory drive.

A

Pressure support ventilation

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11
Q

A respiratory rate (RR) of _________ breaths per minute is recommended for patients not requiring hyperventilation

A

8-12

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12
Q

FiO2 settings

A

The lowest FiO2 that produces:
Arterial oxygen saturation (SaO2) > 90%
PaO2> 60 mm Hg .

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13
Q

Determining Tidal Volume

A

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)

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14
Q

Minute Ventilation

A

Total volume of gas entering lungs per minute (VE)

VE = VT × RR

VT = 500 mL/breath

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15
Q

Primary variables that regulate PaO2

A

FiO2

PEEP- Better choice

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16
Q

A ↓ in PAo2 causes a ___________ (in CV system)

A

hypoxic vasoconstriction

shifts blood away from poorly ventilated regions of lung to well-ventilated regions of lung.

17
Q

Changes in Peak Pressure

A

Suggests airway problem

  • Change in PEEP
  • Change in airway resistance (mucous plug, vent kink, bronchospasm)

-Change in compliance (plateau)

18
Q

Quick changes in plateau pressures (aka lung compliance)

A
  • Pulm Edema
  • Pneumothorax
  • Pleural Effusions
  • Abdominal Compartment syndrome
19
Q

lung compliance

A

change in lung volume for a change in pressure
( ΔV/ ΔP)
inversely proportional to wall stiffness.

High compliance = lung easier to fill
lower compliance = lung harder to fill.

20
Q

Pathology and changes in lung compliance

A

↑ in pulmonary fibrosis, pneumonia, pulmonary edema;

↓ in emphysema, normal
aging.

21
Q

lung compliance equation

A

= ΔV/ ΔP

22
Q

Changes in Peak Pressure from change in airway resistance can be from?

A

mucous plug
vent tube kink
bronchospasm

23
Q

airway resistance is on vent is shown as?

A

Peak Pressure

24
Q

Auto - PEEP physiology

A

Feels like breathing on top of a breath

Incomplete expiration prior to the initiation of the next breath causes progressive air trapping (hyperinflation).

25
Q

With each inspiratory effort, the ventilator delivers a full assisted tidal volume.

A

Assist-control ventilation

26
Q

Consequences of high plateau pressure

A

bara-trauma

27
Q

ARDS and the vent

A

Low tidal volume

increase peep

28
Q

COPD and vents

problems and solutions

A

↑ airway resistance (give bronchodilator)

non-adequate time for expiration ( decrease the RR or shorten inspiratory time)