Term
| What are the different types of respiratory failure? |
|
Definition
| ventilatory failure and oxygenation failure |
|
|
Term
| What is the most common cause of hypercapnic respiratory failure |
|
Definition
| hypoxemia, ventilatory failure |
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|
Term
| Symptoms of oxygenation failure |
|
Definition
| cyanosis, tachycardia, confusion, restlessness, headache, fatigue, bradycarida, hypotension, pulmonary hypertension |
|
|
Term
| symptoms of ventilatory failure |
|
Definition
| headache, lethargic, restlessness, tremors, slurred speech, mood fluctuations |
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|
Term
| What are critical values that establish the presence of respiratory failure. |
|
Definition
MIP <20
VC < 10-15 mL IBW
VD/VT ratio 0.6
ph <7.25
Vt < 3-5 mL/kg |
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|
Term
| What is pressure control ventilation? |
|
Definition
| Every breath is a machine breath at preset pressure. |
|
|
Term
| Trigger, limit, cycle for pressure control |
|
Definition
Trigger- patient or time
Limit- pressure
Cycle- time |
|
|
Term
| What is volume control ventilation? |
|
Definition
| every breath is a machine breath at a preset flow |
|
|
Term
| trigger, limit, cycle of volume control |
|
Definition
trigger- patient or time
limit- flow
cycle- volume reached |
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|
Term
| Peak inspiratory pressure |
|
Definition
| maximal pressure obtained during positive pressure ventilation |
|
|
Term
|
Definition
| the average pressure applied to the airway over a specific time. |
|
|
Term
|
Definition
| the peak alveolar pressure at the end of inspiration, it reflects respiratory system recoil pressure. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pulmonary edema, pneumonia |
|
|
Term
| causes of increased airway resistance |
|
Definition
| COPD, emphysema, chronic bronchitis, bronchiectasis |
|
|
Term
| causes of decreased compliance |
|
Definition
| ARDS, atelectasis, tension pneumothroax, obesity |
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|
Term
| Ventilator settings for normal lungs |
|
Definition
5-8 mL/kg of IBW
10-20 RR
PEEP 5cmH2O |
|
|
Term
| ventilator settings for restrictive lungs |
|
Definition
4-6 mL/kg IBW
RR 15-25
PEEP 5cmH2O |
|
|
Term
| ventilator settings for obstructive lungs |
|
Definition
8-12 mL/kg IBW
RR 8-12
PEEP 5cmH2O |
|
|
Term
| How does flow affect the I:E ratio? |
|
Definition
Increasing the flow rate decreases the I-time.
Decreasing the flow increases the I-time. |
|
|
Term
| Define adaptive support ventilation |
|
Definition
| a mode of ventilation that changes the number of mandatory breaths and pressure support level according to the patient's breathing pattern |
|
|
Term
| What parameters are adjusted to maintain a particular minute ventilation in ASV? |
|
Definition
| pressure support and mandatory rate |
|
|
Term
| How does ASV adjut the ventilator parameters? |
|
Definition
| Pressure support increases until a calculated Vt is able to provide adequate alveolar volume. |
|
|
Term
| ASV: Spontaneous breathing |
|
Definition
| when a patient begins to spontaneously breathe the mandatory rate decreases and the pressure support increases. |
|
|
Term
| ASV: No spontaneous breathing |
|
Definition
| If there is no spontaneous breath the ventilator determines and provides the mandatory parameters to deliver teh preselected Vt, I-time, and I:E ratio |
|
|
Term
| Define proportional assist ventilation |
|
Definition
| a mode that uses variable pressure to provide pressure support. A purely spontaneous mode based on work of breathing, flow demands, reistance and compliance of the lungs |
|
|
Term
| what adjustments are made in PAV? |
|
Definition
|
|
Term
| How and when are the adjustments made in PAV |
|
Definition
| the adjustments are changed with the patient's breathing efforts |
|
|
Term
| define Adaptive Pressure control |
|
Definition
| closed loop pressure control ventilation. the goal is to deliver set Vt at the lowest possible PIP |
|
|
Term
| What is constant with APCV |
|
Definition
|
|
Term
| What is variable with Apcv |
|
Definition
| peak alveolar pressure, flow |
|
|
Term
|
Definition
| spontaneous breathing at alternating levels of peep |
|
|
Term
| What is the difference between APRV and Bilevel? |
|
Definition
| Bilevel you can spontaneously breathe in high or low peep, APRV you can only spontaneously breathe in high peep |
|
|
Term
|
Definition
| moderate to severe ARDS, refractory hypoxemia, inadequate oxygenation, failure of other lung protection strategy ventilation |
|
|
Term
| What are the initial settings for APRV |
|
Definition
High pressure level- 20-30 cmH2O
FiO2- start at 100% then titrate down
Low pressure level- 0-5 cmH2O
high time ratio- 3-5 sec
low time ratio- .2-.8 sec |
|
|
Term
| What are the indications for NAVA? |
|
Definition
| patients with spinal cord injury, head injury, COPD, and ventilator dependency |
|
|
Term
| What variabel is monitored in NAVA? |
|
Definition
| the patient's electrical activity of the diaphragm is used to guide the optimal functions of the ventilator |
|
|
Term
| what is the patient population for NAVA? |
|
Definition
| mainly neonates but can be used on adults and children as well |
|
|
Term
| What is the most important consideration when maintaining a patient on NAVA? |
|
Definition
| maintaining the proper placement of the NG tube |
|
|
Term
| Initial settings for High frequency oscillatory ventilation (adults) |
|
Definition
frequency- 3-8 hz
amplitude- 60-90 cmH2O
bias flow- 20-40L/min
Map- 25-35 cmH2O |
|
|
Term
| How to adjust hz to improve ventilaiton? |
|
Definition
|
|
Term
| which ventilator parameters control ventilation? HFOV |
|
Definition
| Amplitude, Hertz, I-time, bias flow (with an intentional cuff leak) |
|
|
Term
| which ventilator parameters control oxygenation? HFOV |
|
Definition
| mean airway pressure, FiO2 |
|
|
Term
| How do you set amplitude? HFOV |
|
Definition
| dial in amplitude until you have chest wiggle to the mid thigh |
|
|
Term
| How do you set mean airway pressure? HFOV |
|
Definition
| what ever your mean airway pressure was on conventional ventilation add 5 cmH2O |
|
|
Term
| Which parameter is most affective in improving ventilation? HFOV |
|
Definition
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