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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


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