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