MECHANICAL VENTILATION

Question 1

Effects of PPV on right vs. left cardiac dynamics

Answer 1

Worsens Right-Side Dynamice: Decreases RV Preload, Increases RV Afterload

Improves Left-Side Dynamics: Decreases LV Preload, Decreases LV Afterload

Question 2

2 effects of PEEP on cardiopulmonary physiology

Answer 2

Higher PEEP improves oxygenation and decreases work when above the alveolar closing capacity

Higher PEEP decreases preload

Question 3

Variables affecting Minute Ventilation

Answer 3

Tidal Volule (Vt)
Respiratory Rate (RR)

Question 4

Variables affecting oxygenation

Answer 4

Fraction of Inspires 02 (Fi02)
PEEP

Question 5

Lung Protective Settings: Vt, RR, Fi02, PEEP, IFR

Answer 5

Vt: 6 cc / kg
RR: 16
Fi02: 100, titrate down below 60
PEEP: 5
IFR: 60

Question 6

Obstructive Settings: Vt, RR, Fi02, PEEP, IFR

Answer 6

Vt: 6-8 cc / kg
RR: 10
Fi02: 100, titrate down below 60
PEEP: 0-5
IFR: 60

Question 7

Plateau Pressure Target and strategy to decrease

Answer 7

If PP > 30, decreased VTE by 1 ml/kg

Question 8

Approach to Ventilation Issues

Answer 8

Check the patient
Check the vitals
Check the vent

Question 9

DDx: Hypotension

Answer 9

DDx for SHOCK

Vent Specific:
Tension PTX
Auto-PEEP / Dynamic Hyperinflation
Relative Dehydration
Sedation Medications / Post-intubation meds