Study guide flashcards
when dealing with a mediastinal mass what type of intubation should you plan on
fiberoptic, spontaneous respiration
cause of leakage in lungs after thoracotomy
inflammatory mediators at alveolar-endothelial barrier
ALI - what causes stretching of capillaries?
fluid overload causes failure of micro vessels, disturbing permeability
Which side lung lobectomy is better tolerated and why
L lobectomy better tolerated because R lung is bigger and has more blood flow and oxygenation
What can occur during mediastinoscopy (besides hemorrhage and pneumo)
how/why?
Pressure on innominate artery–>decreased cerebral blood flow
reduces flow flow to:
R common carotid
R vertebral
Subclavian flow to R arm
How do we prevent/monitor for too much pressure on innominant artery
- Pulse ox and/or art line on R arm
- BP cuff on L to prevent interruption of R readings
In restrictive lung disease, there is a decrease in
All lung volumes and capacities
In obstructive lung disease, there is an increase in
RV, FRC, TLC
Dominant feature of obstructive lung disease/COPD
progressive airflow obstruction
Increased FRC, RV, TLC
What scenario causes the largest VQ mismatch?
Anesthetized, vented, paralyzed, one lung down, open chest
HPV is triggered by
alveolar hypoxemia
HPV only occurs in
pulmonary circulation
in regular circulation, hypoxemia causes vasodilation
HPV in OLV decreases blood flow by (amount)
50%
Blood flow in HPV (lung ratio)
80:20 instead of 60:40
Potential complicatino with inflating bronchial cuff
bronchial rupture form overinflation
1-3 mL of air in bronchial cuff