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Mech. Vent

Mechanical Ventilation - Units 3-4 SPC

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