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Mech. Vent
Mechanical Ventilation - Units 3-4 SPC
| Question | Answer |
|---|---|
| Conditions associated with increased drive to breath | Increased metabolic rate, metabolic acidosis, anxiety |
| Conditions associated with decreased drive to breath | Sleep Apnea, hypothyriodism, stoke, neck trauma, depressant drugs |
| MEP (Max Expiratory Pressure) | blow as hard as possible into manometer, measures strength of diaphragm, 100 = norm, <40 critical |
| NIF or MIP | measures strength of diaphragm, suck back as hard as possible through manometer, -50 to -100 is norm, <-20 critical |
| Acute Respiratory Failure (ARF) | pH < 7.35, PaO2 < norm for age on O2, PaCO2 >55 and climbing. Inability to keep pH, PO2, PCO2 at acceptable levels |
| Test which most reflects patient's ventilation | CO2 |
| Diseases/disorders associated with increased WOB | effusions, hemothorax, pneumothorax, clot, atalectasis, emphysema, ARDS, edema, fibrotic tissue, increased secretions, bronchoconstriction, flail chest, obesity |
| What is A-a gradient, how to calculate it | increased with age, increases with increased FIO2, indicates amount of shunt. 7 X flow - CO2 = PAO2, then sub the PaO2 and the diff is the gradient. 5-15 is norm, >450 = critical |
| Causes and description of abnorm resp patterns | Tumors, stroke or trauma. Cheyne-stokes = VT increase and then decrease and followed by apnea, associated with waxing and waning. Biot's = RR changes but VT same. Can also affect the glottic response, so airway to be protected |
| Phase variable of a breath | Triggering, Limiting and Cycling |
| Triggering | pt attempts a spontaneous breath...cause breath to begin |
| Limiting | places a maximum value on inspiration. P,V, time, or flow |
| Cycling | Cause Inspiration to end |
| Most frequent methods of triggering | Pressure - Neg P usually set to 1- to-2,Flow drop- flow going in, and time- mostly used in NEOS |
| Variables controlled by vent mode | Triggering, Flow, V, NOT FIO2 |
| Function of chest curasis and troubleshoot | Look for leaks, Neg pressure vent, used in home on pts w/chest wall deformaties or neuromuscular probs. |
| Mandatory Breath | Vent does all WOB |
| Troubles with transport of vented pts | Accidental extubation, loss of IV, hypoxemia, hypervent by overbagging, loss PEEP, postion changes result in hypercarbia, hypoxemia, hypotension |
| Components of Compliance loop | PEEP, V, P |
| What vents most commonly used in home | CPAP, BiPAP, or the neg pressure ones, PONCHO, chest curasis, pneumosuit |
| Definition of controlled and how vents classified | Can control P,V, flow and sometimes time of Inspiration |
| Volume Controlled Vent | VT is constant and limited. RR is set. P and Time vary. Most common parameter found in adult ventilation. Most consistant ABGs |
| Pressure Controlled Vent | P constant and limited. RR is set. V and flow vary. Used in acute lung injury to protect lungs. |
| Definition of Positive Pressure Ventilation | to start breath, P is greater at the mouth than alveoli. P in alveoli builds. At end of I, P @ mouth = 0 and P in alveoli is greater creating at P gradient and the air flows out. Exhalaton is Passive |
Created by:
mac6672
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