Week 7 Pulmonary Function Tests Flashcards
Normal I:E ratio is
I:E ratio in COPD Patients is
1: 2
1: 3
To prevent bronchospasm, _______ releasing drugs should be avoided, such as _______
Histamine
morphine, pentothal, atracurium, mivacurium, neostigmine
Extubation criteria includes
VSS, awake and alert, resp rate < 30
ABG on FIO2 of 40%: PaO2 >70, PaCO2 15cc/kg
Intubation criteria includes:
Mechanics: RR>35, VC350mmHg on 100%FIO2
Ventilation:PaCO2>55 (except in chronic hypercarbia), Vd/Vt > 0.6 (remember normal dead space is 30%)
Clinical: airway burn, chemical burn, epiglotitis, mental status change, rapidly deteriorating pulmonary status, fatigue: all of these situations would call for a RSI rapid sequence intubation
Bicarbonate ion (HCO3) is a __________, a substance that can absorb or donate H+
buffer
an increase in PCO2 by 10mmHg causes a _______ in pH by _______, likewise a decrease of PCO2 by 10mmHg will ________ pH by ______
*Rule: an increase of PCO2 by 10 mmHg causes a decrease in pH by 0.08, likewise, a decrease of PCO2 by 10 mmHg will increase pH by 0.08
The A-a gradient is a
measure of efficiency of lung
Tx for low PaO2 is supplemental O2, adjust ventilation, tx atelectasis, add PEEP, and to most importantly, treat the ___________
underlying cause
a decrease in bicarb. by 10 mmoles ______ the pH by ______, likewise, an increase in bicarb. By 10 mmoles ________ pH by _______
a decrease in bicarb. by 10 mmoles decreases the pH by 0.15, likewise, an increase in bicarb. By 10 mmoles increases pH by 0.15
Total body bicarb. deficit =
= (base deficit * wt in Kg * 0.4), in mEq/L, usually replace ½ of deficit
Respiratory Acidosis presents with __________. Acute and chronic causes include _____________. After 1-2 days ____________ occurs,
H+ excreted by kidney and HCO3- are reabsorbed into blood to _______ correct pH
Low pH & High PaCO2
Hypoventilation with hypercarbia, COPD
Renal compensation
partially
Respiratory Alkalosis presents with ________________. Causes include ______ and __________. Renal compensation will occur causing increased excretion of HCO3- and decreased secretion of H+ which ______ corrects pH
High pH & Low PaCO2
pregnancy and artificial ventilation
partially
Metabolic Acidosis presents with ______ and ______. Causes include ______ and _______
Low pH & Low HCO3-
lactic acidosis and diarrhea
Metabolic Alkalosis presents with ___________. Causes include ____________________.
High pH & High HCO3-
loss of H+ from vomiting or excessive NGT suctioning
The FEV-1 second is the Most important clinical tool in assessing the ____________.
severity of airway obstructive disease
