Week 7 - Management of Breathlessness

Question 1

Describe 6 possible mechanical causes of increased WOB

Answer 1

Increased airway resistance
Increased elastic load
Decreased energy supply
Decreased power
Increased drive to breathe
Increased alveolar surface tension

Question 2

Describe what mechanisms are present in Emphysema

Answer 2

Increase in expiratory airflow resistance
Severe hypoxemia stimulates drive to breathe
Muscles/ joints at a mechanical disadvantage due to passive and dynamic hyperinflation
Increased inspiratory muscle work to hold open floppy airways

Question 3

Name some treatments for increased WOB

Answer 3

Positioning
Breathing re-education
Relaxation
Address balance between supply/demand
Fan therapy
Pursed lip breathing
Sleep
Pacing/ work sequencing
NIV

Question 4

Describe NIV

Answer 4

Generated by volume or pressure cycled machines (Clearways)

Patient triggered or automatic

Question 5

Describe NIV set up

Answer 5

Blood gases
Mask fit
Aim to capture patient RR and pattern
Set trigger level
Airway pressure 10-35 mmH20

Question 6

Describe criteria for NIV

Answer 6

Must be able to control airway
Cough reflex
Spontaneous respiration
Functioning GI tract
Degree of understanding