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Principles of Anesthesia > Anesthesia Ventilators (Exam III) > Flashcards

Anesthesia Ventilators (Exam III) Flashcards

1
Q

What were the deficiencies of older ventilators?

A
  • Couldn’t provide high enough inspiratory pressure
  • No PEEP
  • Offered only volume control ventilation.
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2
Q

What allows driving gas to exit the bellows housing?

A

Exhaust valve

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3
Q

What is fresh gas compensation?

A

Machine compensation meant to prevent FGF from affecting set VT.

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4
Q

What is the inspiratory pause time?
What is another name for this?

A

Inspiratory Plateau = time in which lungs are held in the inflated position.

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5
Q

What is the ratio for inspiration to expiration?

A

1:2 typically

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6
Q

What is inverse ratio ventilation?

A

When I:E is inversed so that inspiratory time is double that of expiratory time.

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7
Q

What is minute volume?

A

VT for one minute = V̇T

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8
Q

When is peak pressure measured?

A

Inspiratory phase

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9
Q

What ventilator valve that allows excess gas to scavenged during exhalation?

A

Spill valve

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10
Q

What is work of breathing?

A

Energy expended by patient/ventilator to inhale and exhale.

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11
Q

What are the factors that affect delivered VT?

A
  • FGF
  • Compliance
  • Leaks
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12
Q

Decreases in compliance cause a decrease in _____.

A

VT

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13
Q

What is the driving gas?

A

O₂ and/or medical air

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14
Q

What alarms are required on a ventilator?

A

Low Pressure
High Pressure

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15
Q

What is a good set point for our pressure limiting mechanism?

A

10 cmH₂O above the patients average inspiratory pressure.

10 cmH₂O above peak pressure.

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16
Q

What allows for observation of the bellows?

A

Bellows Housing (clear plastic cylinder)

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17
Q

What are the advantages/disadvantages of an ascending bellows?

A
  • Safer
  • Descends on inspiration
  • Fails to rise if disconnected
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18
Q

Ascending bellows will _______ on inspiration.

A

descend

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19
Q

What are the advantages/disadvantages of a descending bellows?

A
  • Rises on inspiration
  • Continues to descend (d/t gravity) even if disconnected
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20
Q

What would occur with a bellows if an NGT were placed in the lung?

A

Bellow would collapse & “clap” due to lack of air in the lung.

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21
Q

What factors affect deliver VT?

A
  • FGF
  • Compliance
  • Leaks
22
Q

What is the most commonly used ventilator mode?

A

Volume Control

23
Q

What parameters are set during VC ventilation?

A
  • VT
  • Respiratory rate
  • I:E ratio
24
Q

What should a patients VT be set to?

A

4-6 cc/kg

25
Q

Would V̇T increase or decrease with tachypnea in a patient on volume control?

A

Increase. ↑ RR = ↑ V̇T on VC.

26
Q

What parameters are set with Pressure Control (PC) ventilation?

A
  • PIP
  • RR
  • I:E ratio
27
Q

What factor changes with Pressure Control ventilation?

A

VT

28
Q

What causes changes in tidal volume with pressure control ventilation?

A

Resistance & compliance

29
Q

________ lungs are necessary with pressure control ventilation.

A

Compliant

30
Q

What lung ventilation mode will protect the lung from excess pressures (and thus barotrauma) ?

A

PC (Pressure Control)

31
Q

How would one better fill the lung in pressure control mode?

A
  • ↑ inspiratory time
  • ↑ RR
32
Q

This mode of ventilation prevents sudden VT changes due to compliance.

A

Volume guarantee Pressure Control

33
Q

What’s an example of something that would cause a rapid change in compliance?

A

Loss of insufflation

34
Q

How does Volume Guarantee Pressure Control ventilation work?

A

Maintains VT by adjusting PIP over several breaths

35
Q

This mode of ventilation gives a set tidal volume in response to negative pressure (aka attempted breath).

A

Assist Control (AC) Ventilation

36
Q

Which type of ventilation allows for patient initiated inspiration at variable tidal volumes?

A

Intermittent Mandatory Ventilation (IMV)

37
Q

How do Intermittent mandatory ventilation and Assist Control ventilation differ?

A

Each requires a patient inspiratory effort & negative pressure.
- AC = set tidal volume
- IMV = variable tidal volumes

38
Q

Which type of ventilation allows for breath “stacking”?

A

IMV

39
Q

What is SIMV?

A

Spontaneous Intermittent Mandatory Ventilation

This allows for synchronization of ventilator breaths w/ patient attempted breaths.

40
Q

Which parameters are set with Pressure Support?

A
  • PIP
  • Inspiratory time
41
Q

Which ventilator mode necessitates an apnea alarm?

A

Pressure Support

42
Q

Which ventilator mode would be best for weaning off a ventilator?

A
  1. Pressure Support (PS)
  2. SIMV
43
Q

What are common causes of ventilator failure?

A
  • Disconnection from power supply
  • ↑ ↑ ↑ FGF
  • Fluid in electronic circuitry
  • Leak in bellows housing
44
Q

What two factors could cause a loss of breathing system gas?

A
  • Failure to occlude spill valve
  • System leak
45
Q

100% of a gas is ________ ppm.

A

1,000,000

46
Q

1% of a gas is ______ ppm.

A

10,000

47
Q

Where are higher levels of trace gas noted?

A
  • Pediatric anesthesia
  • Dental surgeries
  • Poorly ventilated PACU’s
48
Q

What issues are potentially associated with trace amounts of VAA’s?

A
  • Spontaneous abortions
  • Infertility
  • Birth defects
  • Impaired performance
  • Cancer
  • Liver disease
  • Cardiac disease
49
Q

What is a passive scavenging system?

A

Exhaled gasses are vented to OR atmosphere and then room ventilation system removes.

50
Q

What is an active ventilation system?

A
  • High volume 30L/min
  • Lots of suction
  • Attached to central vacuum system that directly removes exhaled gasses.
51
Q

What are possible causes of hypercapnia associated with the anesthesia machine and ventilator?

A
  • Hypoventilation
  • Absorbent failure
  • ↑ VD
  • Defective Coaxial system

Principles of Anesthesia (24 decks)

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