stuff 1000+
Vd/Vt unacceptable
>60%
acceptable MIP or NIF
-20 cmH20
Electrical power ventilators use what kind of currents
AC (alternating current) or DC (direct current)
tidal volume is a big driver of ____
Co2
Negative pressure ventilation example
Iron lung
no mandatory breaths in ____ mode
PS or PSV
minute ventilation equation
Vt x RR
use ____ to measure pressure on IPPB
Wright respirometer
PEEP makes it easier to _____
oxygenate and keep alveoli open partially
Raw PIP increases and Plat ____
stays the same
not setting PIP in ____ control
volume
type of ventilation frequently used with infants
pressure control
Vd/Vt normal
20-40%
Vd/Vt is
deadspace
combination vent uses pneumatic power to _____
deliver the breath
IBW comes from ____
sex and height
MIP or NIF normal
-80 cmH20
A-a (21% o2) acceptable
10-15 mmHg
A-a (100%) normal
26-65 mmHg
normal cDyn
35-55 ml/cmh20
tidal volume range for infants
5-10 mL/kg
A-a (21% o2) normal
5-10 mmHG
Minute ventilation normal
5-6 l/min
normal Vt
5-8 ml/kg
tidal volume range for adults
6-12 mL/kg
normal cStat
60-100 ml/cmh20
Cstat normal
60-100 ml/cmh2o
Vital capacity normal
65-75 ml/kg
A-a (100%) acceptable
66-300 mmHg
acceptable RR
8-20 bpm
unacceptable MIP or NIF
< -20 cmH2o
acceptable Ve
< 10 l/min
unacceptable vital capacity
< 10 ml/kg
unacceptable Vt
< 5
unacceptable PH
< 7.35
Qs/Qt normal
< or equal to 5%
Vd/Vt acceptable
< or equal to 60%
Qs/Qt acceptable
<20%
Cstat unacceptable
<25 ml/cmh20
unacceptable Po2
<80
unacceptable Ve
> 10 l/min
unacceptable RR
> 20 bpm
acceptable vital capacity
> or equal to 10 ml/kg
acceptable Vt
> or equal to 5
Qs/Qt unacceptable
>20%
A-a (100%) unacceptable
>300 mmHg
unacceptable PCo2
>45
common causes of Raw
AW secretions or bronchospasms
Mechanical dead space
Amount of circuit tubing between the patient and the wye adapter in the ventilator--in other words it's the space where both exhalation and inhalation passes thru the same path *If mechanical dead space volume equals or exceeds alveolar ventilation volume the patient will not be able to clear carbon dioxide at all
Pneumatically powered vents usually have a ____ so the normal operating pressure is less then the source pressure
pressure reducing valve
positive pressure ventilation example
IPPB ,BiPAP, mechanical ventilators
in assist control and volume ventilation there is NO _____ setting
PIP
Raw equation
PIP-plat
vent checks normally done how often
Q4
cDyn equation
Vt/PIP-PEEP
cStat equation
Vt/Plat-PEEP
SIMV mode avoids ____
air trapping
all vents have a ____ back up if pt forgets to breath
apnea
indications for mechanical ventilation
apnea, cardiac arrest, respiratory failure
all breaths are mandatory in what mode
assist control
decreased lung compliance causes
atelectasis, pulmonary edema, ARDS, pneumonia
optimum PEEP
best PEEP for greatest oxygenation with smallest problems
most current ICU ventilators are powered by
combination
Cstat is
compliance
combination vent uses electric power to _______
control the internal function of the machine
tidal volume is not directly controlled on pressure control vents, use _____ to get desired Vt
delta P
physiological objectives of mechanical ventilation
gas exchange, increase lung volume, reduce work of breathing
Vt varies with
gender, height and age
AC used for
general operation and recharges batteries
when PIP is met pt can ____
go into exhalation
DC used for
power delicate electronics and as a battery power back up
problem with AC
if they try to breath on their own they still get a big breath (start blowing off Co2)
decreased lung compliance PIP increases and Plat _____
increases
treatment for decreased lung compliance
increases PEEP and treat underlying cause
2 reasons for increasing pressures
increasing AW resistance and decreasing lung compliance
if the trigger is too insensitive
machine will not respond even if pt is trying to breath
if the trigger is too sensitive
machine will self cycle (too easy to get a breath)
IPPB machine is ____ control
pressure
IPPB or pneumatic vents are ____ control vents
pressure
record mode specific ventilator settings such as
mode, Fio2, RR, Vt, PEEP, pressure support, alarm settings, flow rates, inspiratory time, trigger
what type of ventilation mimics natural breathing
negative pressure vent
why are volume controls not found on non-electric ventilators
no way for them to respond to volumetric goals
pressure control ventilation is indicated when
oxygenation has been difficult to achieve
what kind of power would you want a ventilator to have if you needed to take a pt into an MRI
pneumatic
record pt values on vent check such as
pts RR, Vt, BP, suctioning results
Volume control ventilation is indicated for
pts with relatively normal lung function who are recovering from sedation or rapidly reversing respiratory failure
pts are often sedated to _____
reduce o2 consumption, minimize vent asynchrony, and get precise & predictable results
clinical objectives of mechanical ventilation
reverse acute respiratory failure, reverse respiratory distress, reduce ICP, stabilize chest call
Qs/Qt is
shunting
______ breaths can be supplemented with pressure support to overcome resistance of the breathing tube
spontaneous
problem with IMV mode
spontaneous breaths can occur at the same time or very near a timed breath
triggering
the effort it takes to inflate a breath
increasing pressure indicates
the lung is becoming harder to ventilate
inspiratory flow is _____ in pressure control
variable
reduced Co2 causes brain _____ which reduces swelling
vasocontriction
generally most ICU vents are ____ controlled
volume
if a pt needed a precise minute ventilation or blood gas parameter was essential to care what type of ventilator would you use
volume control
minute ventilation is being controlled on ______ ventilators
volume control
in AC all breaths are delivered by the ventilator at a preset ____
volume or pressure
Static compliance
•Pressure that is needed to overcome the elastic resistance to ventilation. Is used during periods without gas flow, such as during an inspiratory pause. •Cstatic= vt/plateau-peep 50-100 ml/ cmh20
