Respiratory Failure Flashcards
0
Q
Criteria for intubation
A
- Mechanical failure
- Problem with oxygenation
- problem with ventilation
1
Q
Acute respiratory failure
A
Calls for intubation and extubation
2
Q
Mechanical failure
A
- Respiratory rate greater than 35 per
Min - Vital capacity less than 15 cc/ kg for adults and 10cc/kg for children
- Mif ( maximum inspiratory pressure less than 20 mm of mercury)
3
Q
Problem with oxygenation
A
- Pao2 less than 70mm in the fio2 of 40%
- MIF or NIF of less than 20 mm of water pressure
3.
4
Q
Ventilator problems
A
Major indication for intubation
- Paco2 greater than 55 mmhg
- Dead space to tidal volume ratio greater than 0.6 with normal being 0.3
5
Q
Criteria for extubation
A
- Awake and alert patient with good grip and sustained head lift
- Sustained head lift one if the major signs of readiness for extubation
- respiratory rate less than 30-35
- Hemodynamics stable
- No ionotropic support required
- Vital capacity greater than 15cc/ kg
4.
6
Q
Weaning from mechanical ventilation
A
- TP technique
. TP adapter and a nebulizer is
Connected to endotracheal tube
. Patient is placed in sitting position
. Set fio2 5% higher than what u
Had before
. Check vital signs, respiratory rate
Depth and work as well as
Saturation during the first hour.
If weaning is tolerated extubate
After 2-4 hours - Intermittent mandatory ventilation technique
. IMV is gradually decreased until
Spontaneous ventilation began and
Patient meet criteria for extubation
7
Q
Indication for use of peep
A
- When pao2 is less than 60 with fio2
Greater than 60% - Peep acts by increasing the FRC
- For every 5 mm h2o peep the FRC increases by 400 cc
- Peep improves the relation btw FRC and closing capacity and there by decreases inter pulmonary shunting
- Prophylactic peep 1-5 cm of h2o pressure, conventional peep 5 to 20
- Best peep is when o2 transport is optimized
- Peep deface eases cardiac output by increasing inter thoracic pressure
