Protective Lung ventilation and Driving Pressures Flashcards
(42 cards)
What is the goal of lung protective strategies in mechanical ventilation?
To minimize ventilator-induced lung injury (VILI) and protect the lungs from barotrauma, volutrauma, atelectrauma, and biotrauma.
What tidal volume is recommended in lung protective strategies?
Tidal volume of 6 ml/kg of predicted body weight (PBW).
Why is tidal volume calculated using predicted body weight (PBW)?
PBW reflects lung size and capacity more accurately than actual body weight.
What is the recommended plateau pressure (Pplat) to prevent barotrauma?
Plateau pressure (Pplat) ≤ 30 cmH₂O.
What does plateau pressure (Pplat) represent in mechanical ventilation?
Plateau pressure reflects the pressure needed to inflate the lungs at the end of inspiration.
What is the purpose of applying PEEP in lung protective strategies?
PEEP prevents alveolar collapse at the end of expiration and reduces atelectrauma.
What is atelectrauma in the context of mechanical ventilation?
Atelectrauma occurs when alveoli repeatedly collapse and reopen, causing mechanical injury.
What is permissive hypercapnia, and why is it used in lung protective ventilation?
Permissive hypercapnia allows slightly elevated PaCO₂ to reduce tidal volume and lung stress.
What are the recommended SpO₂ targets to avoid oxygen toxicity in lung protective ventilation?
SpO₂ targets of 88-95% to avoid oxygen toxicity and maintain adequate oxygenation.
What is the principle of open lung ventilation?
Open lung ventilation focuses on recruiting collapsed alveoli and keeping them open throughout the respiratory cycle.
How is optimal PEEP determined in open lung ventilation?
Optimal PEEP is determined through incremental PEEP titration or oxygenation and compliance monitoring.
What is a recruitment maneuver in mechanical ventilation?
A recruitment maneuver involves applying high pressures to reopen collapsed alveoli.
What pressures are typically applied during a recruitment maneuver?
Typically, pressures of 35-40 cmH₂O are applied during a recruitment maneuver.
Why is it important to avoid disconnections from the ventilator in open lung ventilation?
Disconnections can cause lung de-recruitment and alveolar collapse, which must be avoided.
How does open lung ventilation combine PEEP and tidal volume to protect the lungs?
Open lung ventilation combines low tidal volumes (6 ml/kg) with adequate PEEP to maintain alveolar recruitment.
What is the formula for calculating driving pressure?
Driving Pressure = Plateau Pressure (Pplat) - PEEP.
What does driving pressure represent in mechanical ventilation?
Driving pressure reflects the pressure needed to expand the alveoli during tidal volume delivery.
What is the recommended driving pressure to improve outcomes in ARDS patients?
Driving pressure ≤ 15 cmH₂O is associated with better outcomes in ARDS patients.
What does a high driving pressure indicate in mechanical ventilation?
High driving pressure indicates over-distension or poor compliance of the lungs.
How can driving pressure be reduced during mechanical ventilation?
Driving pressure can be reduced by titrating PEEP, reducing tidal volume, and improving alveolar recruitment.
What are the key components of lung protective ventilation?
Low tidal volume, limiting plateau pressure, adequate PEEP, and permissive hypercapnia.
Why is it important to monitor plateau pressure and driving pressure in ARDS patients?
Monitoring ensures lung stress is minimized and ventilator-induced lung injury is prevented.
How does titrating PEEP help optimize open lung ventilation?
Titrating PEEP optimizes alveolar recruitment, improves oxygenation, and reduces atelectrauma.
What is the role of compliance in assessing ventilatory stress on the lungs?
Compliance measures how easily the lungs expand; reduced compliance indicates higher lung stress.
