assisted ventilation

Question 1

2 main types of assisted vent

Answer 1

1. positive pressure

2. negative pressure

Question 2

2 types of neg pressures

Answer 2

1. iron lung

2. rocking bed

Question 3

2 types of pos. pressure

Answer 3

1. non-invasive (BiPAP)

2. invasive - intubate

Question 4

what 2 pressures need to be seton BiPAP

Answer 4

inspiratory and expiratory pressures

Question 5

what determines size of TV in biPAP (2)

Answer 5

1. change in P

2. compliance of lungs

Question 6

3 adv. of intubating

Answer 6

1. stable airway against collapse
2. some protection from macroaspiration
3. allows toileting

Question 7

5 disadv. of intubating

Answer 7

1. uncomfortable
2. can damage airway
3. can’t cough
4. can’t talk
5. not total protection from macroaspiration

Question 8

2 basic settings on PP vent

Answer 8

1. pressure mode - set pressure diff>volume will depend on compliance
2. volume mode - set volume>pressure will depend on compliance

Question 9

2 names of 2 setting on pressure mode

Answer 9

1. PEEP - positive end exp. pressure

2. high/driving pressure

Question 10

2 settings on volume mode

Answer 10

1. PEEP

2. volume

Question 11

what determines O2 levels (2)

Answer 11

1. PEEP

2. FiO2

Question 12

how does ventilation affect O2 and CO2

Answer 12

O2 - not required

CO2 - need to vent out CO2

Question 13

formula for minute vent.

Answer 13

TV*Resp rate

Question 14

what happens in too high FiO2

Answer 14

resorption atelectasis

O2 too soluble>absorbed too fast>unit collapes?shunt

Question 15

probs with too high PEEP

Answer 15

need even higher driving P > impedes venous return > BP drops

Question 16

what is autoPEEP

Answer 16

begin filling before expiration is totally done - overfill

Question 17

how to detect autoPEEP

Answer 17

stop vent and look for flat line on curve before alveoli are empty

Question 18

3 ways to fix autoPEEP

Answer 18

1. prolong expiration time - lower RR or incr insp. pressure
2. decrease obstruction - bronchdilator
3. match with extrinsic PEEP

Question 19

what is key to PP vent

Answer 19

don’t fix gases at cost of lungs

Question 20

2 other ways to help V/Q mismatch

Answer 20

1. prone

2. NO

Question 21

how does NO help

Answer 21

goes to ventilated portions and increase perfusion there

Question 22

disadv. of NO

Answer 22

1. tachyphylaxis - drug tolerance
2. can cause methemoglobemias
3. expensive