Vents Flashcards
This is a form of continuous pressure support ventilation based on two variables; pressure & time;
APRV
APRV and lower inflection point vs upper inflection point:
LIP is first point where alveoli are easily recruited; below the LIP alveoli tend to collapse
UIP is point where alveoli become overdistended and vulnerable to trauma
ARPV seeks to maintain ventilation above the LIP and below UIP
When setting pHigh for APRV, what do we set it to?
You set it to the current plateau pressure
Ex; if plateau pressure is 30 cm H20; then the pHigh is set to 30
When initiating APRV what are the initial parameters set to?
PHigh; set to current plateau pressure; usually 30 cm H20
plow; set to 0
Thigh; usually 4-6 seconds
Tlow: usually 0.5 seconds
If pt becomes hypercapenic or acidotic on ABG during APRV what parameters can we change?
Can increase the frequency of the CO2 release and expiration by decreasing Thigh (decreasing the time spent at the pHigh allows for the patient to offload CO2 and improve hypercarbia )
Reintubation rate successful extubation?
10-20%; this is true even if they meet parameters for extubation
Severe ARDS?
P/F <100
45% mortality rate
MCC of death in ARDS?
Multi-organ failure
What trial showed benefits of prone positioning as an adjunct to severe ARDS treatment?
PROSEVA trial
At least 16hrs proning recommended
HFOV?
Small tidal volumes are delivered (1-4 ml/kg) at a frequency range of 3-15 Hz while keeping a high mean airway pressure
Evidence shows no mortality benefit in ARDS; a mode of ventilation not commonly used or recommended
Maximum amount of air expired after maximal inhalation?
Vital capacity
Functional residual capacity?
RV + ERV
Aspiration pneumonitis;
Chemical injury caused by inhalation of sterile gastric contents
Aspiration pneumonia?
Infectious process caused by inhalation of oropharyngeal secretions that are colonized by pathogenic bacteria
