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30 Cards in this Set
- Front
- Back
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IBW Males |
50+2.3[height(inches)-60] 50+0.91x(height in cm-152.4) cm-152.4) |
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IBW Females |
45.5 + 2.3 [height(inches)-60] 45.5+0.91x(height in cm-152.4) |
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Pplat=tVe/Cstat + PEEP |
Calculation for Plateau pressure Cstat is static lung compliance |
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Min Volume |
(IBWx100mL)/min Ex:77kg×100=7.7L/min For metabolic acidosis increase to 160-200 77kg × 160=12.3 L/min |
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Resp rate |
Minute vent/Vte Current respiratory rate x pc02/ desired pco2 |
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NIV CHF |
6/6=12/6 on additive ventilator increasing expiration pressure as needed to improve oxygenation increased MAP is the goal 6/14 or 6/30 for longer inhalation |
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NIV COPD |
Initial 6/6=12/6 increasing inspiratory pressure as needed to decrease wob,fatigue, and distress increased driving pressure may be needed 24/6 Longer exhalation |
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Pplat >30 |
Decrease tV by 1 mL/kg |
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Pplat <25 |
Increase tV by 1mL/kg |
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pH >7.45 |
Decrease RR |
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pH <7.15 |
Increase tV by 1mL/kg May need to give NaHCO3 |
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Increase o2 |
Increase fio2, increase PEEP, Increase I time |
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Increase Ventilation |
Increase Vte, increase ipressure, increase RR |
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Driving pressure calculation |
pPlat-PEEP=driving pressure
Pressure required for alveolar opening Less than 15 good greater than 15 associated with increased mortality |
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Normal minute ventilation |
4-8 L/M |
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Tidal volume |
4-8 ml/kg ideal body weight Sometimes as low as 4ml/kg in ARDS pts |
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Hypoxic resp failure |
Inability to diffuse o2 ARDs, Pneumonia, CHF Evidenced by po2 <60 Treatment increase fio2 and PEEP Treatment assumes tV and rate have been maintained Increasing fio2,peep, or combination of the two will increase spo2 saturations. Rate and tV will have little to no impact. |
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Hypercarbic Respiratory failure |
Inability to remove co2 Damage to Pons or upper medulla Stroke/trauma Evidenced by Resp acidosis >45mmhg Treatment- increase tV(pPlat) then increase rate Double minute volume (Ve) normal 4-8L/min Use caution exceeding 8mL/kg of IBW for tV settings can cause VILI If pt is achieving adequate tV pPlat(25-30mmhg) begin to slowly increase the rate to achieve Ve of 4-8 L/min and reassess every 15 minutes for improvement |
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Peak inspiratory pressure PIP |
<35cmH20 amount of resistance to overcome the ventilator circuit, any appliances, the ett and the main airways |
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pPlat Plateau pressure |
<30cmh20 Measurement of the pressure applied during ppv to the small airways and alveoli Represents the static end insp recoil pressure of the resp system lung and chest wall respectively |
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Low pressure alarm |
Pt d/c from machine Chest tube leaks Airway leaks Hypovolemia |
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High pressure alarm |
Kinked line Coughing Secretions or mucus in airway Pt biting the tube Reduced lung compliance (pneumothorax/ards) Increased airway resistance |
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Acute respiratory deterioration |
PIP: decreased- airleak, hypoventilation, hyperventilating No change- Pulmonary embolism, extrathoracic process Increased- check pPlat If pPlat increased =decreased compliance: abdominal distention, asynchronous breathing, atelectasis, pleural effusion, endobronchial intubation, autopeep, trendelenburg, pneumothorax, pulmonary edema If no change in pPlat= airway obstruction: aspiration of foreign body, bronchospasm, secretions, trachea tube obstruction, ett cuff herniation, kinked ETT |
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Cm to inches conversion |
divide the length value in cm by 2.54 to get inches |
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Desired o2 per altitude |
Pao2 will decrease by 5 mmhg per 1000' increase in altitude Calculation: %fio2xP1÷P2 P1 current barometric pressure P2 new barometric pressure at altitude |
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Winters formula |
Provides an estimate for baseline co2 for chronic hypercapnea: (HCO3 from BMP x 1.5) + 8 = normal (desired) pco2 Correcting RR based on winters Current pco2 ×current rr÷desired pco2 |
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Auto peep |
Ards or pulmonary edema can present with 3-4 cmh2o of auto peep
If above that in ards or pulmonary edema or if the pt has copd and presents with any auto peep Ensure adequate sedation, 1.reduce RR lowest of 12, 2.Reduce I time(however if pt had high airway resistance trouble getting air in or ards this can increase turbulence in airway or decrease ability to oxygenate) or 3. reduce Vt Also consider taking pt off of ventilator to allow full exhalation while changes are made. High levels of auto peep over a prolonged period of time can result in hypoxia, hypotension, or pneumothorax |
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PPlat-PEEP |
Driving pressure |
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100ml/kg/min |
Minute ventilation |
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Recruitment manuver |
Increase peep by 2 for 2 minutes Check cstat (average of 3) if higher then increase peep by 2 for 2 min Check cstat repeat until no improvement or decrease in ctsat leave peep at highest cstat return |
