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Res 262 – Pediatric
study guide week 1
| Question | Answer |
|---|---|
| Explain what Von Neergaard discovered about the retractile force of the lung | the retractile force of the lung was dependent on the surface tension in the alveoli |
| Describe what creates surface tension | Surface tension is created by the attraction of water molecules to one another |
| What is LaPlace’s Law? | During respiration, carbon dioxide and water are exhaled at the surface of the alveoli, creating a liquid interface with inhaled air. As indicated by the Laplace law, this attraction would lead to the collapse of alveoli as each alveolus becomes smal |
| Know the physiological conditions associated with normal amount of lung surfactant | maintains functional residual capacity. increases lung compliance, promotes homogeneous gas distribution during inhalation, and allows a residual volume of gas to be evenly distributed throughout the lung during exhalation; |
| What structure produces pulmonary surfactant | type II alveolar epithelial cells (pneumatocytes) in the lung |
| List what comprises pulmonary surfactant. | II. Phosphatidylcholine III. Phosphatidylinositol IV. Phospholipids |
| Explain the roles of SP-D. | enhances the binding, phagocytosis, and killing of microbes by alveolar macrophages plays a key role in surfactant homeostasis. |
| Define PG and lecithin and list their functions | Measurement of phospholipids in the amniotic fluid can be used to determine fetal lung maturity, as phosphatidylglycerol (PG) and phosphatidylcholine (lecithin) increase while sphingomyelin decreases during gestation. |
| What are the benefits of administering surfactant to preterm infants? | decrease the risk for mortality, pneumothorax, and pulmonary interstitial emphysema. Surfactant helps to reduce the surface tension in the alveoli so they can remain expanded with air to prevent atelectasis. Studies have demonstrated a reduction in mor |
| Know the differences between synthetic surfactants and bovine surfactants | Synthetic surfactants do not contain any protiens but do contain synthetic lipids. Natural surfactants (from either cow or pig) contain proteins. Natural surfactants seem to benefit the patient more that synthetic. Natural surfactants work faster, allow |
| List the cardiac conditions that can cause surfactant inactivation. | II. Pulmonary hemorrhage, III. Hemorrhagic edema |
| List the conditions associated with meconium aspiration | first if the baby is past its due date Another indication for meconium aspiration would be if the mother suffered from diabetes or hypertension. Lastly an infection could also cause meconium aspiration. |
| What factors are associated with the inability to wean patients with CHD from ECMO? | Severe pulmonary hypoplasia (as indicated by ECMO requirement for their management) Severe pulmonary hypertension Pulmonary edema Surfactant inactivation Complications of surgery |
| List the proteins found in sputum | |
| List the benefits of surfactant | Prevents collapse of lung during deflation (expiration) • Lessens work of breathing (oxygen consumption) • Optimizes surface area for gas exchange and ventilation–perfusion matching • Optimizes lung compliance (high at low lung volumes and low at high |
| What flow wave pattern does the Puritan Bennett LP10 Ventilator use when in different modes | Sinusoidal |
| The SERVO-I ventilator has an optional lung tool, what is it used for? | To assist in determining the inflating and deflating pressures of the lung |
| In the absence of surfactant | distribution of ventilation becomes uneven, the lungs become stiff, and atelectasisensues during exhalation. The result increased work of breathing, hypoxia, and respiratory failure, the clinical picture exemplified by preterm infants with RDS. |
| What are the physiologic benefits of surfactant? | II. Surfactant prevents capillary leakage of fluid into alveoli. III. Surfactant optimizes surface area for gas exchange. IV. Surfactant protects the epithelium of the lung |
| What variables are responsible for terminating inspiration? | Cycle variable |
| List the ‘inspiratory cycle off’’ settings functions, on the Maquet Servo-i | It enables expiration to occur at an earlier point in the peak flow requirements.(allows operator to alter exhalation cycling threshold for pressure support.) |
| List the alarms and what they are associated with on the Maquet Servo 300A ventilator. | Input Power Alarms Control Circuit Alarms Output Alarms |
| Explain the flow-triggered breath associated with the Puritan Bennett 840 ventilator. | When setting the patient on flow triggering, a breath is delivered to the patient from the ventilator when a specific flow of gas has left the circuit. |
| List the waveforms and their functions on the Drager Medical Evita 4 ventilator. | rectangular inspiration flow wave form |
| Describe the pressure-limited ventilation mode. (Drager Medical Evita 4 | I. If peak inspiratory pressure reaches the set Pmax, the ventilator delivers a pressure-controlled breath .III. If the measured inspiratory volume reaches the set tidal volume (VT) before the end of the set inspiratory time interval, inspiratory gas flo |
| What is a baseline variable? | Baseline phase is phase 4 expiration. This is when the change to expiration is made and flow, volume and pressure return to the baseline value. |
| What variables are responsible for initiating inspiration? | Trigger |
| List the control variables. | Trigger limit cycle baseline |
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VivianP
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