CMV Flashcards

1
Q

ventilation

A

normal movement of gases into and out of the lung

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2
Q

external respiration

A

gas exchange b/w the lung and the blood stream

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3
Q

internal respiration

A

gas exchange b/w the blood and the cells - cellular level

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4
Q

on inhalation describe what happens in the thoracic cavity

A

diaphragm descends and enlarges the vertical size of the thoracic cavity, the external intercostals contract and raise the ribs slightly increasing thorax

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5
Q

on exhalation describe what happens in the thoracic cavity

A

exhalation is passive and diaphragm returns to normal position

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6
Q

what must you have to have flow

A

must have pressure gradient to have flow

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7
Q

what causes a volume change

A

gas flow

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8
Q

when is there no gas flow

A

at end of inhalation and end or exhalation

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9
Q

what pressure do you measure vent pressure in

A

cmH2O

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10
Q

what reference is equal to 760 mmhg for vents

A

zero reference

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11
Q

proximal pressure is often called what

A

Pawo or Pm

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12
Q

unless pressure is applied the upper airway Pawo is what

A

zero

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13
Q

what is intrapleural pressure (Ppl)

A

pressure in the potential space b/w the parietal and visceral pleura

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14
Q

Nml intrapleural pressure is what at the end of expiration and what at the end of inspiration

A

-5 and -10

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15
Q

what changes as intrapleural pressure changes

A

alveolar pressure (intrapulmonary pressure) Pa

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16
Q

what are the four basic pressure gradients

A

transairway pressure, transthoracic pressure, transpulmonary pressure, transrespiratory pressure

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17
Q

transpulmonary pressure

A

alveolar pressure - pleural pressure

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18
Q

transthoracic pressure

A

alveolar pressure - body surface pressure

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19
Q

transairway pressure

A

airway pressure - alveolar pressure

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20
Q

transrespiratory pressure

A

airway pressure - body surface pressure

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21
Q

where do you measure pressure

A

very close to the mouth or inside ventilator

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22
Q

baseline pressure

A

usually pressure at end expiration before next breath

23
Q

what raises baseline pressure

24
Q

peak pressure

A

highest pressure recorded at the end of inspiration

25
plateau pressure
breath hold / inspiratory pause - elastic recoil of lung is still exerting a pressure
26
when is plateau pressure taken
after breath has been delivered but before exhalation is allowed to occur
27
compliance
volume change per unit of pressure change
28
dynamic compliance
reflects elastic recoil of lung (stiffness) and airway resistance to flow
29
static compliance
pressure is measured at static or no-flow conditions and eliminates airway resistance
30
resistance
obstruction to air flow
31
what is EEP
end expiratory pressure or baseline pressure
32
what is normal compliance value
0.05 to 0.17 L/cm H2O or 50 to 170 mL / cm H2O
33
what is the normal compliance value of intubated patients
males: C = 40 - 50 mL/cmh2o up to 100 mL/cmH2O females: C = 35 -45 mL/cmH2O up t 100 mL/cmH2O
34
normal resistance values
0.6 to 2.4 cmH2O/L/sec at 0.5 L/sec flow
35
resistance values for intubated patients
approx. 6 cm H2O/L/sec or higher
36
when does the RAW increase for intubated patients
increases as the endotracheal tube size decreases
37
clinical conditions that increase RAW - COPD
emphysema, chronic bronchitis, asthma, bronchiectasis
38
clinical conditions that increase RAW - mechanical obstruction
post intu obs, FB obs, endotracheal tube, condensation in tubing
39
clinical conditions that increase RAW - infection
croup, epiglottitis, bronchiolitis
40
what is the time constant
the product of R and C which has units of time
41
why is the time constant called constant
for any value of R and C equals the time necessary for the lungs to empty 63% of volume
42
2-time constants
86%
43
3-time constants
95%
44
4-time constants
98%
45
5-time constants
100%
46
one time constant = what
C x RAW
47
what does the C and RAW stand for
c = compliance of the unit and RAW is resistance of the unit
48
time constant formula
time constant = C x R
49
types of mechanical ventilation
negative pressure, positive pressure, high-frequency
50
who uses high - frequency ventilation
infants IRS, adults with air leaks, ARDS
51
what is high - frequency ventilation
high rates and low volumes
52
HFPPV
60-100 breaths/min
53
HFJV
100-600 breaths/min
54
HFO
up to 4000 breaths/min