ARTP 11

Question 1

Max values allowed during CMV for PiP, Plat, and MAP

Answer 1

Pip 50
MAP 12
Plat 30

Question 2

Factors that can affect hemodynamics

Answer 2

TV, PiP, PEEP, PS, i:e (inverse)

Question 3

Benefits of adding PEEP

Answer 3

1. Improves FRC
2. Improves LC
3. Improves oxygenation
4. Tx of atelectasis

Question 4

Difference between CPAP/PEEP

Answer 4

CPAP rides solo dolo, while PEEP is CPAP but with additional settings (PS, rate, ect.)

Question 5

Unwanted affects of adding PEEP

Answer 5

Decreased BP/CO, increased PiP and risk of barotrauma, and increased ICP

Question 6

What patients need PEEP?

Answer 6

ARDS/Flail Chest/peds

Question 7

Optimal PEEP requirements (5)

Answer 7

Best oxygenation with; Best compliance, CO, and PaO2. With lowest PiP and FiO2

Question 8

Which pt population usually has very high RR and we are OKAY with it?

Answer 8

DKA- Kusmaul’s (Very deep, very fast)

ARDS

Question 9

Two goals of permissive hypercapnia

Answer 9

Improve oxygenation and protect the lung

Question 10

Initial TV settings for COPD/ARDS/Neuro/Asthma exacerbation

Answer 10

COPD 6-8ml/kg
ARDS 4-8ml/kg
Neuro 6-10ml/kg
Asthma exacer. 4-6ml/kg
**Normal: 6-8mL/Kg

Question 11

When should you use a heated wire circuit over an HME?

Answer 11

If the pt is on the vent for longer than 2 days.

If pt has copious/thick/bloody secretions.

Question 12

How do you fix your CO2 problem?

Answer 12

Increase or decrease VE

Question 13

What is a primary complication of deliberate hyperventilation?

Answer 13

If you hyperventilate a pt who has a TBI too quickly, it will result in tetany/seizures/arrythmias

Question 14

What is your CO2 and ICP goal for a pt with TBI?

Answer 14

PaCO2 of <35 to reach an ICP of <20mmHg. Once ICP goal reached, begin decreasing the rate

Question 15

What static LC and RSBI indicate readiness to wean?

Answer 15

LC >25 mL/cmH2O

RSBI <105

Question 16

PETCO2 that is more than 5 < PaCO2 indicates what dz process?

Answer 16

Pulmonary Embolism

Question 17

Desired FiO2

Answer 17

(Desired PaO2 x Current FiO2)/Current PaO2

Question 18

New Vent rate

Answer 18

(Current Rate x Current PaCO2)/Desired PaCO2

Question 19

New VE on vent

Answer 19

(Current VE x Current PaCO2)/Desired PaCO2

Question 20

Airway resistance Formula

Answer 20

(PiP - Plat)/V

**V is flow

Question 21

CaO2 Formula

Answer 21

(SaO2 x Hb x 1.34) + (PaO2 x 0.003)

Question 22

During initial vent set up what do you do with PEEP?

Answer 22

Do not add Peep unless it is indicated

**Initial vent assessment is usually done without PEEP

Question 23

Compressed TV

Answer 23

PiP x TC

Question 24

Drowsiness/lethargy are cardinal signs of what?

Answer 24

hypercapnia

***this means they are hypoventilating

Question 25

Mild hypoxemia

Answer 25

60-79

Question 26

Normal oxygenation

Answer 26

80-100

Question 27

When would you use A/C + PEEP in ARDS?

Answer 27

if alveolar hypoventilation is occuring.