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Anesthesia Equipment* > Ventilators > Flashcards

Ventilators Flashcards

1
Q

Minute Ventilation

A

Respiratory rate x Tidal volume

Normal range: 5-6 L/min

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2
Q

I:E

A
  • Inspiratory: Expiratory Ratio
  • How much of each ventilation cycle is devoted to inspiration & expiration
  • Normal range: 1:2 or 1:3 in COPD patients
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3
Q

PIP or PAP

A

Peak Inspiratory Pressure or Peak Airway Pressure

  • Measured by the ventilator in the major airways
  • Strongly reflects the airway resistance
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4
Q

Ventilator Functions

A
  • Ventilate patient

- Oxygenate patient

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5
Q

Plateau Pressure

A

Positive pressure supplied the small airways and alveoli

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6
Q

What pressure should we aim to keep plateau pressure under and why?

A

Goal is to keep plateau pressure under 30cmH20, because excessive alveoli stretch is thought to be the cause of ventilator induced lung injury

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7
Q

Peak Flow

A
  • Determines the rate if tidal volumes delivery to the patient during mandatory volume control breaths.
  • It affects the I:E and peak pressure
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8
Q

What are the ventilator modes?

A
  • Volume Control Ventilation (VCV)
  • Pressure Control Ventilation (PCV)
  • Pressure Support Ventilation (PSV)
  • Synchronized Intermittent Mandatory Ventilation (SIMV)
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9
Q

Volume Control Ventilation (VCV)

A

Tidal volume is preset and resultant airway pressure is a function of lung compliance and other factors

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10
Q

Independent variable(s) of Volume Control Ventilation (things you can set)

A

Tidal Volume, Respiratory rate , I:E ratio, FiO2, and PEEP (optional)

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11
Q

Dependent Variable(s) of Volume Control Ventilation

A

Peak inspiratory pressure, Plateau pressure

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12
Q

Pressure Control Ventilation (PCV)

A

Peak airway pressure is preset and the delivered tidal volume is a product of lung compliance and other factors

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13
Q

Advantage(s) of volume control ventilation

A
  • Guaranteed minute ventilation

- May help lung compliance in certain surgeries (abdominal or chest surgeries)

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14
Q

Disadvantage(s) of volume control ventilation

A
  • Patient does not trigger breath but can see patient effort in capnogram
  • May need to reduce tidal volumes if you get high PIP/PAP
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15
Q

Independent variable(s) of pressure control ventilation

A

Inspiratory Pressure, Respiratory Rate, I:E Ratio, FiO2, PEEP (optional)

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16
Q

Dependent Variable(s) of Pressure Control Ventilation

A

Tidal volume

17
Q

Advantage(s) of pressure control ventilation

A
  • reduced ventilator induced lung injury
  • improved gas distribution because it uses decelerating flow
  • more rapid improvement in lung compliance and oxygenation compared to VCV
18
Q

Disadvantage(s) of pressure control ventilation

A

-Does not guarantee minute ventilation

19
Q

PIP vs Plateau Pressure in VCV

A
  • PIP is determined from tidal volume set
  • Plateau pressure is determined by applying an inspiratory hold (0.5 -1 sec). Hold represents no flow, which gives the pressure the alveoli are seeing
20
Q

PIP vs Plateau pressure in PCV

A
  • PIP is usually the same as plateau pressure because of how breath is delivered
  • There is an inherent inspiratory pause
21
Q

Pressure Support Ventilation (PSV)

A

Spontaneous ventilation mode that provides constant pressure once patient inspiratory effort is detected

22
Q

Independent variable(s) of Pressure Support Ventilation

A

-Support pressure, Inspiratory time, flow trigger, FiO2, PEEP (optional)

23
Q

Dependent Variable(s) of Pressure Support Ventilation

A

Tidal volume, respiratory rate

24
Q

Advantage(s) of Pressure support ventilation

A
  • Able to have patient breathe spontaneously and not fight the ventilator
  • Able to augment tidal volume
  • Able to adjust ETCO2 with support pressure
25
Q

Disadvantage(s) of Pressure support ventilation

A

-requires patient to breathing spontaneously

26
Q

Synchronized Intermittent Mandatory Ventilation (SIMV)

A
  • Breaths are given at preset time intervals
  • Patient can breathe spontaneously between the ventilator breaths
  • ventilator will not give a breath if the patient inspires at that same instant
27
Q

Independent Variable(s) of SIMV

A

Tidal volume, respiratory rate, I:E ratio, FiO2, Pressure support Level, PEEP (optional)

28
Q

Dependent Variable(s) of SIMV

A

Peak inspiratory pressure, plateau pressure

29
Q

Advantage(s) of SIMV

A
  • Can be used as a way to start building up CO2

- Back-up mode for PSV

30
Q

Disadvantage(s) of SIMV

A

-May confuse the patient’s brain because it is not physiological

31
Q

If I:E ratio is 1:2 (normal) and RR is 10 breaths/min, how long are the inspiratory and expiratory times?

A

60 seconds/RR = 6seconds/breath
Inspiratory time = I/I+E (6) or 1/3(6)
I = 2 seconds E = 6 - I = 4 seconds

32
Q

Inspiratory Pause (Tip)

A
  • holds breath at end of inspiration (before exhalation starts)
  • Allows breathe to diffuse better
  • Only available with VCV
  • Usually 25% of inspiratory time
  • Takes time from inspiration & adds it as a hold (expiration remains the same)
33
Q

if the I:E ratio is 1:2 and the RR is 10 breaths/min and the inspiratory pause is set at 25%, how much time is spent in inspiration, inspiratory pause, and expiration?

A 
I = 1.5 sec
Tip = 0.5 sec
E = 4 secs
34
Q

PEEP

A
  • constant positive pressure applied at the end of exhalation
  • causes airway pressure to not return to 0cmH20
35
Q

Auto PEEP

A
  • air trapping in the lungs because of insufficient exhalation time
  • not a setting
36
Q

What are the signs of Auto PEEP?

A
  • Non-zero end expiration pressure

- Increasing PIP/PAP

37
Q

Ventilator settings for tidal volume

A

500 -700 ml (adults)

6-10 ml/kg (infants, children, and COPD patients)

38
Q

Ventilator settings for Respiratory Rate

A

10 breaths/min (initial setting)

39
Q

Ventilator settings for Minute Ventilation (Ve)

A
  • VT x RR
    • 4 x BSA (Men)
    • 3.5 x BSA (Women)

Anesthesia Equipment* (2 decks)

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