Ventilator Flashcards
What are the two different ventilator strategies? And give examples?
Obstruction: Asthma, COPD
Injury: ARDs, pneumonia
The lung injury strategy is ____ in nature and against what sort of dangers?
PROTECTIVE
BAROTRAUMA
In Assist Control mode, what are the parameters that can be altered?
Tidal Volume
Inspiratory Flow Rate
Respiration Rate
FiO2/PEEP
To achieve lung protection, what parameter should be addressed and how?
tidal volume.
low tidal volume, undershoot in the 6-8cc/kg range
What should the plateau pressure be?
And how do you achieve that target?
plateau pressure <30
decrease tidal volume
The IFR setting serves what purpose for the patient? How is the IFR quantified and what does it mean?
Comfort for the patient.
High IFR is fast inspiration.
Low IFR is slow inspiration.
The patient is sucking on ET tube, what setting should be address and how?
Patient wants air (inspiration)
Increase the IFR
What ventilator setting addresses ventilation?
Respiratory Rate
How is the dead space affected when a patient is placed on the ventilatory? What should be addressed respectively on the settings?
Dead Space increases. Aim for a higher respiratory rate.
What aim does FiO2/PEEP achieve? How should it be managed?
oxygenation.
Start big and titrate down.
The FiO2/PEEP can benefit the patient in what four ways?
1) improve V/Q mismatch
2) decrease shunt
3) improve spont. breathing
4) decrease atelectasis/trauma
What is the goal in the obstruction ventilator method?
focus on the time to breath out
What setting is affected very little by the obstruction ventilator method? What’s the aim?
tidal volume.
8cc/kg
How is IFR different when the patient has obstruction issues?
higher IFR.
Could be 80-100 LPM.
Type II respiratory failure is what short of issue? What about type I? What type is obstruction?
Type II ventilation.
Type I oxygenation.
Type II.
What’s a typical PEEP in the obstruction patient? What role does PEEP play in this patient?
Zero.
Higher PEEP works against the patient.
What kind of respiratory rate would you expect in obstruction patients?
Low. It’s a good idea to start around 10 BPM.
When addressing the respiratory rate, the I:E time can be altered. What’s the normal I:E and how does it change for the obstruction patients?
1: 2 is typical.
1: 4 and 1:5 is frequent in obstruction patients.
What is the I:E affected in obstruction patients?
They need a longer time to breath out.
What obstructive patient state makes sedation/analgesia so important? (two words)
permissive hypercapnea
If the plateau pressure is >30 in the obstruction patient, what is happening and how can it be addressed?
Autopeeping so decrease the RR.
Patient is airtrapping, what is your response?
decrease the RR.
