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Mech. Vent

Mechanical Ventilation - Unit 2 SPC

What is responsive Hypoxemia? Significant response to increase FIO2. Due to V/Q mismatch. A 20% increase in FIO2 = 10mmHg increase in PaO2
What is refractory Hypoxemia? No increase in PaO2 with increase in FIO2. Due to combo of anatomic and capillary SHUNT
What is Deadspace? Ventilation w/o Perfusion = High V/Q. From Pulmonary Embolism
What is Pulmonary/Capillary Shunt? Perfusion w/o Ventilation = Low V/Q. From ARDS, pneumonia, atelectasis.
Normal V/Q? they should match = 1.0 but normal is 0.8
PaO2/FIO2 (PF) ratio lower is worse. <300 = acute lung injury, <200 = ARDS
Normal PaO2/FIO2 (PF) ratio 400
Calculate Minute Ventilation RR X Vt(Tidal V)
Calulate VD/VT (PACO - PECO)/PACO, Normal VD/VT = .30, pt w/Puml. Embolis have higher ratios
Calculate Effective Minute Ventilation VA = (1-VD/VT) x RR x Vt
Calculate Static Compliance Remember Stat = Plat, Vt/(Plat - PEEP if any)
Normal Static values 0.05-0.17 L/cmH2O or 50-170ml/cmH2O
Static measures what? Lung Compliance w/o airflow
Calculate Dynamic Compliance Vt/(Peak - PEEP if any)
Dynamic measures what? Airway resistance during airflow
Static Compliance is altered by changes in Lung and Thorcic compliance
Dynamic Compliance is altered by Lung, Thoracic AND AIRWAY Resistance
Calculate Airway Resistance Peak-Plat pressure/Flow
Normal Airway Resistance Value 1-2 cmH2O/L/sec, Athsma and Emphysema is 13-18
Tissue Resistance caused by non elastic tissues in contact with Respiratory Tract, i.e. great blood vessels, certain muscles, and some upper ab contents
Name the 3 Deadspaces Anatomical, Alveolar, Mechanical
Anatomical Deadspace Conducting Airways
Mechanical Deadspace Re-breathed gas from Mechanical attachments
Alveolar Deadspace Gas not reaching functioning gas exchange units
What alters THORACIC Compliance Shit that affects the chest wall, Kyphoscoliosis, Pectus Excavatum, Ascites, Obesity, Chest Strapping, Diaphragmic impairment
Factor that alter LUNG, THORACIC, STATIC, and DYNAMIC Compliance Congestion(CHF, Pulmonary Edema), Atelectasis, Fibrosis, Emphysema, Pneumonia
Relationship between PACO2 and pH When starting at PACO2 of 40, for every 20 increase, the pH decreases .10, ... for every PACO2 decrease of 10, pH increases by .10
Changes in BiCarb caused by PACO2 for every 10 increase in PACO2, HCO3 increases 1,...for every 10 decrease in PACO2, HCO3 decreases 1.5
30 is 60, 60 is 90, and 40 is 75 If PO2 = 30 sat is 60, 60 is 90, and 40 is 75(VENOUS)
If suction cath meets resistance... get tube with smaller diameter.
Created by: mac6672