cardiopulm week 15 mechanical ventilation

Question 2

What are the clinical goals of mechanical ventilation?

Answer 2

To meet physiologic needs until pulmonary system has recovered.

Question 3

What are the indications for mechanical ventilation?

Answer 3

1. Acute respiratory failure (failure to maintain an adequate balance of pH, PaO2, PaCO2)
2. Protection of the airway and lung parenchyma (drug overdose, CVA, head injury)
3. Relief of upper airway obstruction (tumor, allergic reaction, edema)
4. Improvements of pulmonary hygiene in patients with excessive secretions.

Question 4

What are the complications of mechanical ventilation?

Answer 4

1. Oxygen toxicity
2. Barotrauma (pneumothorax, acute lung injury)
3. Decreased CO (because positive pressure on the lungs makes it harder to pump blood)
4. Complications related to endotracheal tube (palate injuries)
5. Ventilator associated pneumonia.

Question 5

What are the two types of ventilators?

Answer 5

Negative pressure and positive pressure.

Question 6

Negative pressure ventilation is used for patients who do not need what?

Answer 6

An artificial airway (patients with polio).

Question 7

For positive pressure ventilation, if volume is preset then pressure is what?

Answer 7

Variable.

Question 8

For positive pressure ventilation, if pressure is preset then volume is what?

Answer 8

Variable.

Question 9

What is a self-initiating bag valve mask resuscitator used in emergencies?

Answer 9

Ambu bag.

Question 10

What are the two types of artificial airways?

Answer 10

Endotracheal tube and tracheostomy.

Question 11

What is a type of artificial airway that is short term and can be placed in the mouth or nose?

Answer 11

Endotracheal tube.

Question 12

What is a type of artificial airway that is long term?

Answer 12

Tracheostomy.

Question 13

What does AC stand for in mechanical ventilation?

Answer 13

Assist control.

Question 14

What does SIMV stand for?

Answer 14

Synchronized intermittent mandatory ventilation.

Question 15

What does CPAP stand for?

Answer 15

Continuous positive airway pressure.

Question 16

What does PSV stand for?

Answer 16

Pressure support ventilation.

Question 17

What does PEEP stand for?

Answer 17

Positive end expiratory pressure.

Question 18

What does NIPPV stand for?

Answer 18

Noninvasive positive pressure ventilation.

Question 19

What does FiO2 stand for?

Answer 19

Fraction of inspired oxygen.

Question 20

What are three ventilator settings you should know before touching a vent?

Answer 20

1. Mode of ventilation (tidal volume and rate)
2. FiO2
3. PEEP.

Question 21

What are assisted modes of mechanical ventilation?

Answer 21

AC and SIMV.

Question 22

In assisted modes of mechanical ventilation, who does the work and starts/stops the breath?

Answer 22

Ventilator.

Question 23

What are spontaneous modes of mechanical ventilation?

Answer 23

CPAP and pressure support.

Question 24

In spontaneous modes of mechanical ventilation, who does the work and starts/stops the breath?

Answer 24

Patient.

Question 25

What is PEEP?

Answer 25

The pressure remaining in the lungs at the end of expiration (keeps the alveoli from collapsing).

Question 26

If PEEP is too high, what can the patient not do?

Answer 26

Exhale (because the alveoli won't close).

Question 27

What is the normal PEEP?

Answer 27

3-5.

Question 28

What PEEP range is used to treat refractory hypoxemia and acute lung injury?

Answer 28

5-15.

Question 29

What PEEP level is used only for severe lung injury?

Answer 29

> 15.

Question 30

What is used when short term ventilation is expected and to avoid intubation?

Answer 30

Non-invasive positive pressure ventilation (NIPPV).

Question 31

What are the two forms of NIPPV?

Answer 31

CPAP and BiPAP.

Question 32

What does CPAP provide?

Answer 32

One continuous pressure that the patient has to inhale and exhale against (used for sleep apnea).

Question 33

What does BiPAP provide?

Answer 33

Two continuous pressures, one for inhalation, and one for exhalation.

Question 34

NIPPV usually takes the form of what?

Answer 34

A mask that the patient can wear prn or full time.

Question 35

What are the types of NIPPV masks?

Answer 35

1. Face mask 2. Full face mask 3. Nasal mask 4. Nasal pillow.

Question 36

Before starting a PT session, what should you know?

Answer 36

1. Reason why patient requires mechanical ventilation 2. Ventilator settings 3. Respiratory rate 4. Oxygen saturation.