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Mech/Vent Unit 2

SPC Mechanical Ventilation Unit 2 Exam 1

QuestionAnswer
What is Ventilation? The volume of air inspired per minute. Ventilation rate of humans is 4-5L/min.
What is Perfusion? The bulk flow of blood from the right ventricle to pulmonary capillaries (through the pulmonary arteries) and back to the left atrium (through the pulmonary veins). Perfusion rate is about 5L/min.
What is deadspace? Ventilation without Perfusion
What is an example of deadspace? Pulmonary Emboli
What is Pulmonary Shunt? Perfusion without Ventilation
What are examples of Pulmonary Shunt? Atelectasis, pneumonia, ARDS
What is Normal Unit? Ventilation matches Perfusion Ideally 1.0 but normally 0.8
What is Silent Unit? No Ventilation & No Perfusion
The A-A O2 Gradient is also know as what? Alveolar-Arterial O2 Gradient
What ratio has to do with the A-A Gradient? PaO2/FIO2
What ratio of PaO2/FIO2 is considered normal? >200 mmHg
What ratio of PaO2/FIO2 is considered severe oxygenation? <200 mmHg
What does PaO2 stand for? Partial Pressure of Arterial O2
What does PAO2 stand for? Partial Pressure of Alveolar O2
What is the normal range for the PaO2/PAO2 ratio? 0.75-0.95 or 75%-95%
What percent is considered poor oxygenation transfer and increased shunting in calculating PaO2/PAO2? 30%
What percent is considered critical in calculating PaO2/PAO2? 15% or less
What is Responsive Hypoxemia? Hypoxemia that has a significant response to an increase in FIO2 simply due to V/Q mismatch
What is Refractory Hypoxemia? Hypoxemia that does not respond to an increase in FIO2 due to combination of anatomic and capillary shunting
What is the equation for Physiologic Dead space? Anatomic + Alveolar = Physiologic Dead space
What is the abbreviation for Anatomical Dead space? (VD anat)
What is the abbreviation for Alveolar Dead Space? (VD alv)
What is the abbreviation for Mechanical Dead Space? (VD mech)
What is Anatomical Dead Space? Gas Volume in the conducting airways
What is Alveolar Dead Space? Gas which DOES NOT reach functioning gas exchange
What is Mechanical Dead Space? Re-breathed gas from mechanical attachments like tubing
What does PECO2 stand for? Partial Pressure of Exhaled O2
Exhaled O2 can be collected in what? Douglas Bag or Capnometry
What is the Normal Value for PECO2? 28 mmHg
VD/VT is an abbreviation for what? Dead Space Ventilation per Breath
What formula is used to calculate VD/VT? (PaCO2-PECO2)/PaCO2
What is the normal range for VD/VT? 20%-40%
What percentage of VD/VT is incompatible with spontaneous respiration? >80%
Mechanically Ventilatted patients usually have what VD/VT? 50% or greater
What other patients may have a high VD/VT? Pulmonary Embolus patients
What is the abbreviation for Alveolar Ventilation? (VA)
What is the formula for (VD) Dead Space Volume? VT x (VD/VT) = VD
What is the formula for (VA) Alveolar Ventilation? (VT-VD)f = VA
What is Lung Compliance? Stretch ability of lung tissue
What is Thoracic Compliance? Stretch ability of the chest wall
What is Total Compliance? The sum of the reciprocals of both lung and thoracic compliance
What is normal (CL) Lung Compliance? 200 ml/cm H2O or 0.2 L/cm H2O
What is normal (CC) Thoracic Compliance?
What is the formula for Total Compliance (CT)? 1/CL + 1/CC = 1/CT
What is Static Compliance? Compliance measured at a point of no airflow
What is Dynamic Compliance? Compliance measured during airflow
What is the compliance formula for Static and Dynamic compliance? (Volume/Pressure) or (Liters/cmH2O) or (ml/cmH2O)
What is the normal range for static and dynamic compliance?
What is the Static Compliance Calculation? Volume delivered by Ventilator/(Static Airway Pressure - Baseline Pressure)
What is the Static Compliance Calculation? Volume delivered by Ventilator/(Peak Airway Pressure - Baseline Pressure)
What does PIP stand for? Peak Inspiratory Pressure
What does PEEP stand for? Positive End-Expiratory Pressure
What 5 factors that alter compliance? 1. Congestion (congestive heart failure, pulmonary edema) 2. Atelectasis 3. Fibrosis (scar tissue in the lung) 4. Pneumonia 5. Emphysema (Floppy lungs are very compliant)
What 6 factors alters Thoracic Compliance (chest wall) outside the lung? 1. Kyphoscoliosis (severe curvature of the spine) 2. Pectus Excavatum (sunken chest with depressed sternum) 3. Ascites (Excess fluid in the gut) 4. Obesity (Pickwickian Syndrome) 5. Chest Strapping 6. Diaphragmatic Impairment
Static Compliance will be altered by changes in what? Both Lung and Thoracic Compliance
Dynamic Compliance will be altered by changed in what? Both Lung and thoracic Compliance BUT also by changes in Airway Resistance
What is Airway Resistance?
What is the abbreviation for Airway Resistance? (Raw)
What is the calculation for (RAW) Airway Resistance? (RAW) = PIP - "P(Plateau)"/flow
Conscious individuals will have a resistance of what? 1-2 cmH2O per liter/sec
Patients with obstructive disease with have resistance of what? 13-18 cmH2O per liter/sec or more
What is Tissue Resistance?
What 3 factors affect airway resistance? 1. Types of gas flow 2. Nature of Airway 3. Airway Patency
Smooth, Laminar flow results in what kind of resistance? Low
Rough, Turbulent flow results in what kind of resistance? True
Upper airways make what percentage of (Raw)? 40-45%
Narrow or curved airway results in what kind of resistance? High
Wide or straight airway results in what kind of resistance? Low
Patients with artificial airways i.e. ET Tubs or Tracheostomy will have resistance of what? 5-7 cmH2O per liter/sec
What is the normal range for pH of ABG? 7.35-7.45
What is the normal range for PaCO2 of ABG? 35-45 mmHg
What is the normal range for PaO2 of ABG? 80-100 mmHg
What is the normal range for HCO3 of ABG? 22-26 mEq/L
What is the normal range for Base Excess of ABG? -2 to +2
What is the relationship between changes in PaCO2 and pH? When starting at a PaCO2 of 40mm Hg, for every 20 mm Hg increase in PaCO2 , the pH decreases by 0.10 units ALSO When the PaCO2 decreases by 10 mmHg, the pH increases by 0.10 units.
What is a probable VENOUS sample? pH 7.37, pCO2 47, pO2 41, HCO3 22, SaO2 75 or less
Created by: Langhout1418