mechanical ventilation settings Flashcards
(29 cards)
what are the 3 reasons for mechanical ventilation
- Failure to ventilate- form of respiratory failure
- Failure to oxygenate- not oxygenating or is retaining CO2 (form of respiratory failure)
- Need to protect airway- patients ability to sneeze, gag or cough has been dulled and aspiration is possible
hypoxemic
PO2 < 60
hypercapnic
PaCO2 > 50
tidal volume
8-10 mL/kg of ideal body weight
respiratory rate
10-14 breaths per minute
inspiratory:expiratory ratio
1:1.5, 1:2
1:3 for normal mechanics
1:4 w asthma or COPD exacerbations
inspiratory flow rate
40 L/min to 60 L/min
PEEP
5 cm H2O
FIO2
100%
sensitivity
-2 cm H2O
ARDS (acute respiratory distress syndrome)
- life threatening lung injury characterized by difficulty breathing and low blood oxygen levels
- caused by damage to the lungs, often from infection or trauma, which leads to fluid buildup and impaired gas exchange
PEEP
positive end expiratory pressure
what should PEEP be set at
5
what should FIO2 be set at to start with
100%
tidal volume for pt with ARDs
< or equal to 6ml/kg standard body weight
end inspiratory airway pressure for pt with ARDs
< or equal to 30 cm H2O
control mode
total control of ventilation: machine breaths for pt at a preset rate, FIO2, VT, flow rate, I:E ratio
requires sedation or mechanically induced coma
no active respiratory muscle activity required
assist control mode
ventilator provides a preset tidal volume or pressure at preset rate
assists pt when they take a breath
Pt attempts to breath->generates negative pressure-> machine sense this and provides set tidal volume
SIMV mode
- Synchronized inspiratory mandatory ventilation
- Delivers preset number of breaths at set today volume and flow rate
- Synchronized to pt’s efforts: Ventilator lets pt take breath and assists if landing on machine breath
typical H20 pressure settings for CPAP
5-20 cm H2O pressure
NIPPV
- continuous positive airway pressure (CPAP): constant pressure is maintained throughout the respiratory cycle w/ no additional inspiratory support
- bilevel positive airway pressure (BiPAP): MD sets both the expiratory positive pressure and the inspiratory positive airway pressure with respirations triggered by the patient
What kind of alarm sounds if tubing is kinked?
o High pressure alarms, blockage
o Pressure in circuit should not exceed a certain value
peak pressure alarms set no higher than…
35-40 cm H2O
what alarm sounds if tubing becomes disconnected
low pressure alarm
