Ventilatory Support: Invasive and Non-invasive

Question 1

what are two types non-invasive ventilation?

Answer 1

• continuous positive airway pressure (CPAP)
• bilevel positive airway pressure (BPAP)

Question 2

• maintains the same pressure throughout the breathing cycle
• aids in recruitment of alveoli
• functional residual capacity is increased
• ventilation perfusion match is improved
• lung compliance is optimized
• work of breathing is lessened
• helps with oxygenation

Answer 2

CPAP

Question 3

two levels of airway pressure:

Inspiratory positive pressure

• on inspiratory the patient receives the inspiratory pressure to increase tidal volume and minute ventilation
• resulting in alveolar ventilation
• decreased PaCO2 levels
• relief of dyspnea
• reduce accessory muscle use

Expiratory positive airway pressure (EPAP)

• On expiration the patient receives the expiratory pressure
• increases FRC
• increase PaO2 Levels

Answer 3

Bilevel positive airway pressure

Question 4

What are indications for non-invasive ventilation?

Answer 4

• obstructive sleep apnea
• acute exacerbation of COPD
• cardiogenic pulmonary edema
• asthma
• pneumonia
• post extubation for respiratory failure
• palliative care or neuromuscluar disorders

Question 5

contraindication of non-invasive ventilation?

Answer 5

• respiratory arrest, apnea
• uncontrolled vomiting
• absence of upper-airway reflexes
• pneumothorax
• facial and/or airway trauma
• total airway obstruction
• excessive secretions

Question 6

reasons to switch to invasive ventilation?

Answer 6

• worsening pH and CO2 levels
• hemodynamic instability
• severe tachypnea
• inability to clear secretions
• decreasing level of consciousness
• inability to tolerate the mask

Question 7

• used to assist breathing when patients cannot do so on their own
• can be accomplished via: artifical airway- endotracheal tube, trach

Answer 7

mechanical ventilation

Question 8

indications for mechanical ventilation

Answer 8

hypoxemic respiratory failure

• Pao2/FiO2 ratio less than 200

Hypercapnic respiratory failure

• increased ventilatory dead space
• increased CO2 production
• decreased alveolar ventilation

Need to protect the airway

Question 9

the number of breaths per minute that the ventilator delivers

Answer 9

respiratory rate (RR)

Question 10

the amount of air breathed in our out during normal inspiration
-6 to 8ml/kg of ideal body weight
may go to 4ml/kg for ARDS

Answer 10

Tidal volume (VT)

Question 11

• amount of time it takes to deliver the tidal volume or pressure to the lung

Answer 11

inspiratory time

Question 12

provides a small amount of pressure during inspiration to help the patient draw in a spontaneous breath

Answer 12

pressure support

Question 13

• amount of pressure present in the airway at the end of expiration
• increases oxygenation
• prevents collapse of alveoli

Answer 13

PEEP- postitive end expirtory pressure

Question 14

• the amount of oxygen the ventilator delivers
• 21%-100%
• ABGs and pulse oximetry will be used to determine what FiO2 the patient needs

Answer 14

FiO2- fraction of inspired oxygen

Question 15

• pressure measured in the major airways
• the amount of pressure needed to inflate the lung

Answer 15

Peak inspiratory pressure- PIP

Question 16

• distending pressure on the alveoli
• end inspiratory pause on the ventilator will generate this

Answer 16

Plateau pressure

Question 17

• the volume of air which can be inhaled or exhaled from a person’s lungs in one minute
• normal is between 4 and 5 liters

Answer 17

Minute Ventilation