Miscellaneous for Midterm exam Flashcards
What vent setting is used to fight atelectasis?
PEEP
Compliance formula =
Change in volume
_______________
Change in Pressure
ECMO pump is set on free mode, what does this mean?
The pump is not paying attention to anything.
ECMO pump is set on Stand Alone mode, what does this mean?
The pump is servoregulated by safety mechanisms / parameters.
IRV
Inspiratory Reserve Volume
Amount of air that you can still breathe in if you needed to.
TV
Tidal Volume = (6 - 8 mL/kg)
Normal volume in/out during a normal respiration.
ERV
Expiratory Reserve Volume
Amount of air that you can still breathe OUT if you needed to.
RV
Residual Volume
Amount of air you have left in the lungs after a maximal expiration. (Air not able to breathe out)
IC
Inspiratory Capacity
VT + IRV
FRC
Functional Recidual Capacity
RV + ERV
VC
Vital Capacity = Maximum amount of gas that we can expire after a maximal expiration.
IRV + VT + ERV
TLC
Total Lung Capacity
Mnemonic used to remember my lung volumes ?
L I T E R
How could an increase in PEEP compromise ECMO function ?
↑ PEEP = ↑ Oxygenation, but also ↑ Intrathoracic pressure
which leads to ↑ pressure of the heart specially the RA which would therefore compromise VENOUS DARINAGE.
Vent Settings for an Adult ?
FiO2 PIP PEEP VT R
FiO2: 60% PIP: 15 PEEP: 1 -3 VT: 6 - 8 R: 12 - 15
Vent Settings for an Neonate ?
FiO2 PIP PEEP VT R
FiO2: 60% PIP: 20 PEEP: 1 -3 VT: 8 - 10 R: 20
Blood flows through the hollow fibers of the dialyzer, and a cleansing fluid , known as a dialysate solution, flows in the opposite direction. This configuration maximizes the removal of wastes. Throughout this process, the waste molecules move from a higher concentration in the blood to a lower concentration in the dialysate.
CRRT
This type of CRRT removes fluid without the need for replacement fluids. This can help prevent or treat fluid overload in cases when waste products don’t need to be removed, or the pH levels don’t need to be corrected. This method doesn’t use a blood pump the way other systems do– it’s driven instead by the patients’ own blood pressure; Arterial to Venous. Apparently it doesn’t work well to clear BUN or creatinine. Karen the CVVH goddess says that it doesn’t get used much anymore.
Slow Continuous Ultrafiltration (SCUF)
This type of CRRT removes large volumes of fluids and waste from the patient. It then uses replacement fluids (also known as a substitution solution), which are devoid of toxins, to maintain electrolyte and acid base balance.
Continuous Venovenous Hemofiltration (CVVH)
Initially developed for the management of hemodynamically unstable patients with acute renal failure, It is now is also used for management of fluid overload and acid-base disturbances resulting from conditions such as acute pulmonary edema, congestive heart failure, septic shock, and oliguric states in which pharmacologic or parenteral nutrition therapy necessitates administration of large volumes of fluids.
Continuous arteriovenous hemofiltration
fluid (in the form of water molecules) can pass through the semipermeable filter membrane, and by applying a suction pump on the far side of the membrane, you can suck water out of the patient, through the filter, at apparently whatever rate you’d like. This is called “creating a transmembrane pressure gradient”
Hemofiltration AKA Ultrafiltrtation
It’s an interesting thing about molecules – they’re adventurous. They want to go places. But – and they’re very serious about this - it’s really important for them to spread themselves around evenly; they want to travel with their friends, or not at all. If they see a place where they’re under-represented, over across yonder semi-permeable membrane for example, (Montana, maybe), well, off they’re gonna go, until there’s just as many over there across the border in Montana as there are over here in Idaho. Wyoming maybe. Nice, compulsive little ICU-personality molecules. “diffusion across a concentration gradient”. Of course the membrane has to have holes in it to let ‘em through, right? Just the right size holes too, ‘cause ya don’t wanna be losing your albumins and all, or your red cells.
This treatment can produce really enormous changes in the patient’s body over a pretty short time: they can pull off volume very quickly, change electrolyte and BUN/cr concentrations quickly – that kind of thing, and patients with hemodynamic problems just don’t like that very much.
Hemodyalisis
What is the name of the port through which volume is removed from a hemoconcentrator?
Effluent Port
pressure control mode of mechanical ventilation that utilizes an inverse ratio ventilation strategy. APRV is an applied continuous positive airway pressure (CPAP) that at a set timed interval releases the applied pressure.
APVR
