Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
16 Cards in this Set
- Front
- Back
|
Assignment |
Egan RC chap 46 page 1034, WB 335 to 337 |
|
|
Definitions of ventilatory modalities: IPPB |
Intermittent positive pressure breathing: IPPB Application of positive pressure to the airway for a therapeutic effect Positive pressure creates a pressure gradient Increase mean airway pressure which causes mechanical bronchodilation Incraese airway lumen size and increase alveolar distension |
|
|
Definition of ventilatory modalities: CPAP |
Continuous positive airway pressure Positive pressure maintained in the airway during spontaneous breathing Increase alveolar distension Increases FRC and leads to decrease Shunt Increases oxygenation Increase SaO2 (oxygenation) INcrease PaO2
|
|
|
CPAP |
Reduce WOB TIdal volume and rate determined by patient (because its spontaneous breathing) Last step before extubation
|
|
|
Definitions of ventilatory modalities: CMV |
Continuous mechanical ventilation: CMV (continuous mechanical ventilation) :Controlled ventilation ::Delivers gas volume at a predetermined cycling pattern
:Assisted Ventilation ::Patient has the ability to initate ventilation
Assist:control (AC) ::Patient has the ability to initiate ventilation ::But is guaranteed a "controlled" backup rate Life support: manipulates ventilatory pattern and airway pressure
Increases efficiency of ventilation and or oxygenation |
|
|
Effects of mechanical ventilation |
Increase P(TP) trans pulmonary pressure Increase intrathoracic pressure Decrease venous return preload Decrease cardiac output starlings law |
|
|
Effects of mechanical ventilation |
Decrease renal perfusion Increase ADH :Decrease urine output Increase intercranial pressure ICP |
|
|
Definitions of ventilatory modalities: PEEP |
Positive end expiratory pressure (PEEP) Static positive pressure held in the airway following expiration and prior to the next inspiration :Increases mean P(AW) Increase FRC which leads to increase C(L) :Distents underinflated alveoli: recruits alveoli :Increase oxygenation |
|
|
Definitions of ventilatory modalities: IMV |
Intermittent mandatory ventilation (IMV) :Synchronized (SIMV) Spontaneous breathing combined with mandatory ventilator breaths Used in weaning :Allows patients to gradually assume the work of breathing :Increase respiratory muscle work |
|
|
Definitions of ventilatory modalities: PCV |
Pressure control ventilation (PCV) Preset pressure is maintained throughout inspiration :Volume is variable, if volume goes up, means compliance when up, if volume goes down, compliance went up Preset inspiratory time :No spontaneous breathing Used to manipulate airway pressure :P(IP) :increase P(AW) mean airway pressure :Increase oxygenation
|
|
|
Definitions of ventilatory modalities: PCIRV |
Pressure controlled inverse respiration ventilation For patients that cannot oxygenate, so need to keep air in long time but they changed this to APRV airway pressure release ventilation, also called biway ventilation. Patient does not need to be paralyzed, they can breath spontaneously on this, unless PCIRV where they needed to be paralyzed so its not longer around
APRV is used for patients that do not oxygenation evey with peep and high PCV's. this is like PCV but inverse in the ratio so instead of 1:3 IE ratio it would be 3:1 I:E ratio (ARDS use APRV) |
|
|
Definitions of ventilatory modalities; PSV |
Pressure support ventilation (PSV) Spontaneous breathing, supported by vent Preset inspiratory pressure is maintained during spontaneous breathing :inspiratory pressure :Volume, T(I) or i time and flow are variable. we set the inspiratory pressure Achieved by flow generators delivering high gas flow to maintain preset pressure With CPAP, volume is variable Pressure is maintained throughout inspiration Used for weaning, comfort, and decreased WOB |
|
|
Pressure support ventilation PSV |
Pressure constant: Volume and flow variable Patient breaths are spontaneous in nature :But all are pressurized Preset pressure occurs quickly as the patient inhales Pressure is maintained throughout the inspiratory phase of respiration :If increase volume for same pressure = increase C(L) PSV patients on PSV C(L) = change in V over change in P if compliance goes down, volume goes down with pressure constant With VC, as compliance goes down, pressure goes up PSV is always used with peep(peep is static pressure maintained in the airway) |
|
|
Effects of tidal volume on lung mechanics |
Tidal volume :normal 5 to 7 ml/kg IBW :Tidal volume is composed of V(A) + V(D) :PCV: V(T) varies inversely with changes in C(L) and R(AW) ::If inspiratory time is sufficient, changes in R(AW) will not alter V(T) but will shorten period of no flow Functional Residual capacity (FRC) :Varies directly with PEEP level :In restrictive disease, as PEEP and FRC increases, lung compliance increases (increase C(L))) until lung overdistention occurs |
|
|
Effect of PEEP on lung mechanics |
Effect of airway pressure on lung recruitment PEEP distends or keeps alveoli open :Extrinsic PEEP, mechanically controlled on the ventilator :Intrinsic (auto) PEEP results from gas trapping ::Breath starts before exhalation is complete ::breath stacking |
|
|
Effects of PEEP on Lung Mechanics |
ok |
