ICU

Question 1

give examples of ICU

Answer 1

Major surgery
* Heavy head trauma
* Shortness of breath
* Coma
* Hemodynamic deficiency
* Heavy liquid imbalance
* Multiple organ failure
* Trauma

Question 2

Airway closure in
dependent regions
* Degradation of bodygravity relationship
* Collapse
* Consolidation,
pneumonia
* Lobar atelectasis
* ARDS, Acute lung injury
* Respiratory muscle
weakness /fatigue

are all related to ?

Answer 2

lung volum loss

Question 3

> 7 days MV duration , 25% muscle weakness

true or false?

Answer 3

true

Question 4

when there is inability to leave the MV what will happen?

Answer 4

Peripheral muscle weaknessRespiratory muscle
weakness (+)

Question 5

Prognosis, hemodynamic stability, sepsis,
encephalopathy, neuropathy,
gangrane,contracturs
are related to which assessment in ICU?

Answer 5

organ failure

Question 6

ETT/tracheostomy
IV lines, feeding tubes
Pulse oximeter,
Walking skill
Wheelchair
Portable O2 support
Hemodynamics
HR, Bf, SaO2
, BP
ICP- CPP
Sedation
are all for?

Answer 6

security and mnitoring in ICU

Question 7

what are the Physiotherapy applications in ICU?

Answer 7

Positioning
Kinetic therapy
Mobilization
Airway cleaning
techniques
Exercise training
Respiratory muscle
training
Respiratory
exercises
Incentive spirometry
NIV & CPAP

Question 8

• Postural drainage
• Manual techniques
• ACBT
• PEP treatment
• Manual hiperinflation
• Aspiration
• High Frequency Sky Oscillations (Vest, Hayek)
• Intrapulmonary percutaneous ventilation (IPV)
• Mechanically assisted coughing
• • NIV

are for?

Answer 8

airway cleaning techniques

Question 9

what is the positioning is suggested and applied every 4-8 hrs?

Answer 9

body gravity relationship

Question 10

what positions are applied in ICU?

Answer 10

high lying
side lying
prone

Question 11

which position is applied like?
30-45°
* Aspiration pneumonia risk decreases
*PaO2/FiO2 increases
for
Hypotension
Traumatic brain injury

Answer 11

high lying

Question 12

we use side lying position for what?

Answer 12

*Unilateral lung disease
*Effected side at the top side
lying
* PaO2 ↑
Pulmonary abscess
Pulmonary hemorrhage
Dependent on hemodynamic
stability

Question 13

Pulmonary compression decrease
* More evenly transpulmonary
pressure
* More homogenous lung
perfusion
* Participation of dorsal lung
areas
* Intrapulmonary shunt
* Excretion of secretions increase
* V/Q increase
*Acute respiratory failure
*ARDS
Trauma-surgery
Gastroesophageal reflux

are for which position?

Answer 13

prone position

Question 14

what is kinetic therapy?

Answer 14

• Continuous lateral rotation(≥40°)
• 6-8 laps,> 18 hrs / day
• Atelectasis decreases
• Secretion accumulation decreases
• MV duration decreases
• ICU time decreases
• Prevent airway closure in
  dependent areas
• Risk of infection decreases

Question 15

how can we do early mobilization for ICU patients?

Answer 15

Progressive tilting
* Sitting on the edge of the
bed
* Transfer to chair
* Ambulation with walker
* 30 m walking
Physiotherapy session (x2)

Question 16

what can we do for non mobilized patients?

Answer 16

NMES
passive ROM
passive strtching
CPM

Question 17

Transition time 200-400 s
Stimulation frequency 8-50 Hz
Frequency 3-5 day
Time 4-6 weeks
are for?

Answer 17

NMES

Question 18

for Acute exacerbation of COPD
Type 2 fiber cross section decreases
Type 1 fiber cross-section increases
true or false?

Answer 18

false

Question 19

Peripheral muscle strength
* Exercise capacity
* Thigh circumference 
* Resistance to fatigue
* Transfer from bed to chair
are all increased or decreased with NMES in acute OCPD?

Answer 19

icreased

Question 20

give examples of respiratory exercises

Answer 20

Thoracic expansion
exercises
and spirometry

Question 21

when respiratory exercises are done?

Answer 21

post operative

Question 22

what is CPAP?

Answer 22

continuous positive airway pressure

Question 23

when CPAP is used?

Answer 23

Acute cardiogenic
pulmonary edema
* Early post-op period
* Type 1 respiratory failure
* Inhalation injury
* Trauma
* Pneumonia

Question 24

what is the severity of the resistance exercises?

Answer 24

1 RM 50-70%

Question 25

Acute hypercapnic respiratory failure * Separation from MV * Respiratory Physiotherapy are for?

Answer 25

Noninvasive mechanical ventilation-1

Question 26

SaO2  Alveolar ventilation in Noninvasive mechanical ventilation are?

Answer 26

increased

Question 27

Inspiratory muscle fatigue * Airway closure * Dyspnea * Sputum excretion * Respiratory muscle load * MV duration  * Nosocomial pneumonia * ICU time * Re-intubation * Mortality are all decreased in NIV true or false?

Answer 27

true

Question 28

how can we achieve airway cleansing?

Answer 28

Inspiratory volume Expiratory volume  Expiratory flow rate are all increased with aspiration and oscillation

Question 29

how can we achieve airway cleansing?

Answer 29

Inspiratory volume Expiratory volume  Expiratory flow rate are all increased with aspiration and oscillation

Question 30

* Cough * Huffing * Forced expiration technique * Mechanically assisted coughing can increase?

Answer 30

expiratory flow rate

Question 31

* TV increaseds * Expiratory flow rate increases * Dyspnea decreased * oxygenation increased with?

Answer 31

Mechanic insufflator exsufflation

Question 32

Mechanic insufflator exsufflation is?

Answer 32

cough assist

Question 33

* External manipulation of thorax * Hayek * VEST areb used for?

Answer 33

oscillations

Question 34

Atelectasis improves in ?

Answer 34

High frequency oscillations VEST & Hayek

Question 35

what are indications of aspiration?

Answer 35

Cough * Significant secretion, * Rough breathing sounds * Airway pressure desaturation * Respiratory work

Question 36

with what we can increase expiratory volume?

Answer 36

PEP and CPAP PEEP