Ventilator Management Flashcards
Ventilation vs Oxygenation
Ventilation: Movement of air in and out of the lungs
Oxygenation: Delivery of oxygen to the tissue
Compliance
Stretchability
Relationship between volume and pressure when ventilating
Resistance
Changes in pressure are proportional to changes in flow, and changes in resistance inversely proportional to flow
V/Q Ratio
Ventilation/Perfusion ratio
Atelectasis
Collapse of alveoli
Atelectrauma
Injury to the absolute cause by constantly opening and closing
Barotrauma
Injury to the lungs caused by pressure
VAP
Ventilator associated pneumonia
Occurs within 48 hours of ventilation
Ideal Body Weight males
(# of inches >60) x 2.3) + 50
Ideal Body Weight females
((# > 60) x 2.3) + 45.5
Minute Ventilation (Ve)
Adult: 100mL/kg IDW
Peds: 150mL/Kg
Infant: 200mL/Kg
Tidal Volume (Vt)
4mL/kg: injured/noncomplaint alveoli
6mL/kg: normal setting
8mL/kg: increased minute ventilation
Ideal Body weight less than 8
IBW = 2 x Age (years) + 9
Ideal body weight greater than 8
IBW = 3 x Age (years)
Rate (R)
Minute ventilation/tidal volume
Reasons to increase PEEP
Hypoxia
Atelectasis
Pulmonary edema
I:E ratio
Adult 1:2
Peds: 1:3
Infant: 1:4
Peak Inspiratory Pressure (PIP)
Maximum 35 cmH20
Plateau Pressure
Maximum 30 cmH20
Driving pressure
Pplat - PEEP
Less than 15
Oxygenation problem
Identification:
Spo2
PaO2
Solution:
FiO2
PEEP
Ventilation Issue
Identification:
ETCO2 monitoring
PaCo2
Solution:
Respiratory rate
Tidal volume
High pressure alarm
Obstruction
Cough
Decrease compliance
Pneumothorax
Low pressure alarm
Dislodged ETT
circuit leak
Deflated ETT
First adjustment on ventilator
TV first, not rate