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Mech/Vent Unit 6 & 7

SPC Mechanical Ventilation Unit 6 & 7 PPV

QuestionAnswer
Effects of PPV on Gas Distribution: Diaphragm can become less compliant (aka atrophy) if there is no what? Spontaneous Breathing
Effects of PPV on Gas Distribution? 1. Gas flow takes path of least resistance 2. Gas is redistributed to non-dependent regions. Alters V/Q
Effects of PPV on Gas Distribution: Increases size of conductive airways causing what? Increased Deadspace
Effects of PPV on Gas Distribution: Over-distended alveoli constrict blood flow causing what? Increased Deadspace
Effects of PPV on Gas Distribution: Increased VT and improvement of ventilation may lead to what? Decreased Deadspace
Effects of PPV on Pulmonary Blood Flow? 1. PPV/PEEP decreases C.O. 2. Redistribute pulmonary perfusion to lung periphery 3. Blood forced out of non-dependent lung regions 4. PEEP decrease pulmonary shunting
Effects of PPV on Pulmonary Blood Flow: Blood forced out of non-dependent lung regions means what? 1. Causes V/Q mismatch 2. Increases Deadspace
Effects of PPV on cardiovascular system? 1. Increase pressure to ALL thoracic vessels 2. Decrease in venous return to thorax 3. Decrease RV filling (preload) 4. Decrease SV 5. Decrease CO 6. Decrease SBP
Effects of PPV on ICP? PPV increases CVP (can be observed by jugular vein distension) decrease venous return then increase volume of blood in the cranium then increase ICP then decrease CPP (cerebral perfusion pressure) Results in Potential for Cerebral Hypoxemia
Effects of PPV on ICP: Greatest Clinical Risks 1. Patients who already have increased ICP's 2. Closed Head Injurys 3. Cerebral Tumors 4. Post-neurosurgery
Effects of PPV on Renal System? Decrease C.O. then Decrease renal blood flow then Urine output also Decrease C.O. then Decrease renal blood flow then increase ADH then decrease urine formation
Effects of PPV on Renal System: Redistribution of blood flow in the kidney means what? 1. Flow to outer cortex decreased, Flow to inner cortex increased. 2. Results in less urine, creatinine and sodium being excreted 3. Sodium reabsorbed = reabsorption of water
Effects of PPV on Renal System: Urinary output reduced as renal arterial pressure drops when? <75 mmHg but may stop if severe
Air Trapping with PPV can cause what? Increased alveolar pressure to be transmitted to the intrapleural space like an artificial peep effect. This can cause a decrease in venous return and a decreased C.O.
Importance of body positioning in PPV: Unilateral Lung Disease? 1. Independent lung ventilation (2 vents) 2. Place patient in a lateral position so that the "good lung" is down or in the dependent position.
Importance of body positioning in PPV: ARDS? Prone positioning may improve oxygenation
What are the 4 types of Barotrauma associated with PPV? 1. Subcutaneous Emphysema 2. Pneumomediastinum 3. Pneumothorax 4. Pneumopericardium
Created by: Langhout1418