Podcast
Questions and Answers
In Case 2, what action should be taken to return the PaCO2 levels to normal?
In Case 2, what action should be taken to return the PaCO2 levels to normal?
Decrease the respiratory rate (RR) to 12 breaths/min.
What is the necessary inspiratory flow to achieve the given settings in Case 1?
What is the necessary inspiratory flow to achieve the given settings in Case 1?
The necessary inspiratory flow is 3571 L/min.
What ventilator change is appropriate for the patient in Case 3 with hyperoxemia?
What ventilator change is appropriate for the patient in Case 3 with hyperoxemia?
The FiO2 should be decreased to 0.38.
What is the tidal volume set for the patient in Case 2 on SIMV-VC mode?
What is the tidal volume set for the patient in Case 2 on SIMV-VC mode?
What is the PEEP setting for the patient in Case 2?
What is the PEEP setting for the patient in Case 2?
Identify the primary problem indicated by the ABG results in Case 2.
Identify the primary problem indicated by the ABG results in Case 2.
For the patient in Case 1, what is the set breathing rate?
For the patient in Case 1, what is the set breathing rate?
What would be the consequences of hyperoxemia as shown in Case 3?
What would be the consequences of hyperoxemia as shown in Case 3?
What is the primary goal when managing a patient with respiratory alkalosis as indicated in the first case?
What is the primary goal when managing a patient with respiratory alkalosis as indicated in the first case?
How should you adjust the mechanical ventilation settings for the patient with bilateral pneumonia experiencing mild hypoxemia?
How should you adjust the mechanical ventilation settings for the patient with bilateral pneumonia experiencing mild hypoxemia?
In the case of the comatose patient with a head injury, what would be the most appropriate action regarding FiO2?
In the case of the comatose patient with a head injury, what would be the most appropriate action regarding FiO2?
For the adult patient with a PIP of 41 and Pplat of 33, what should be monitored to prevent complications?
For the adult patient with a PIP of 41 and Pplat of 33, what should be monitored to prevent complications?
What vent settings should be modified for a patient to achieve desired PaCO2 while on AC-VC mode?
What vent settings should be modified for a patient to achieve desired PaCO2 while on AC-VC mode?
When is it appropriate to use pressure control ventilation in patients with severe respiratory conditions?
When is it appropriate to use pressure control ventilation in patients with severe respiratory conditions?
In mechanically ventilated patients, why is monitoring blood gas values vital?
In mechanically ventilated patients, why is monitoring blood gas values vital?
What does a PaO2 of 65 indicate in the context of mechanical ventilation?
What does a PaO2 of 65 indicate in the context of mechanical ventilation?
Flashcards
Inspiratory flow
Inspiratory flow
The rate at which air is delivered to the lungs during inspiration.
AC-VC (Assist-Control Ventilation - Volume Control)
AC-VC (Assist-Control Ventilation - Volume Control)
A ventilation mode where the ventilator delivers a preset volume of air (VT) at a set rate, regardless of the patient's effort.
SIMV-VC (Synchronized Intermittent Mandatory Ventilation - Volume Control)
SIMV-VC (Synchronized Intermittent Mandatory Ventilation - Volume Control)
A ventilation mode where the ventilator delivers a preset volume of air (VT) at a set rate, but the patient can trigger additional breaths.
Tidal Volume (VT)
Tidal Volume (VT)
The amount of air delivered to the lungs with each breath.
Signup and view all the flashcards
PEEP (Positive End-Expiratory Pressure)
PEEP (Positive End-Expiratory Pressure)
The pressure applied to the lungs at the end of expiration. It prevents lung collapse.
Signup and view all the flashcards
Respiratory Acidosis
Respiratory Acidosis
A state where the body is not getting enough oxygen or is eliminating too much carbon dioxide, leading to a low pH in the blood.
Signup and view all the flashcards
Respiratory Alkalosis
Respiratory Alkalosis
A state where the body is getting too much oxygen or eliminating too much carbon dioxide, leading to a high pH in the blood.
Signup and view all the flashcards
FiO2 (Fraction of Inspired Oxygen)
FiO2 (Fraction of Inspired Oxygen)
The fraction of oxygen in the air delivered to the lungs.
Signup and view all the flashcards
What is respiratory alkalosis?
What is respiratory alkalosis?
Respiratory alkalosis occurs when the body eliminates too much carbon dioxide (CO2). Elevated pH and low PaCO2 are characteristic of this condition.
Signup and view all the flashcards
What is the initial treatment for respiratory alkalosis?
What is the initial treatment for respiratory alkalosis?
The goal is to adjust the ventilation settings, specifically the tidal volume (Vt), to achieve a desired PaCO2 level. This is the first step in addressing respiratory alkalosis.
Signup and view all the flashcards
How do we manipulate PIP in a ventilator?
How do we manipulate PIP in a ventilator?
When the vent mode is Pressure Control (PC) or Pressure Regulated Volume Control (PRVC), manipulating the peak inspiratory pressure (PIP) allows for adjustments to achieve the desired tidal volume. This approach is particularly suitable for patients with respiratory alkalosis.
Signup and view all the flashcards
What is mild hypoxemia?
What is mild hypoxemia?
Mild hypoxemia refers to a mild reduction in blood oxygen levels (PaO2). This often indicates the need to increase oxygen delivery to improve the patient's blood oxygenation.
Signup and view all the flashcards
How do we address mild hypoxemia?
How do we address mild hypoxemia?
Increasing the Positive End-Expiratory Pressure (PEEP) helps to improve oxygen exchange in the lungs, thereby addressing mild hypoxemia.
Signup and view all the flashcards
Why is PEEP important?
Why is PEEP important?
PEEP (Positive End-Expiratory Pressure) is a ventilation parameter that helps to keep the alveoli open at the end of expiration. It is vital for maintaining lung volume and improving oxygen exchange.
Signup and view all the flashcards
What does a high PIP indicate?
What does a high PIP indicate?
When a patient's PIP (Peak Inspiratory Pressure) significantly exceeds their plateau pressure (Pplat), it suggests a high airway resistance. This can lead to complications like ventilator-induced lung injury (VILI). By manipulating PIP, we can potentially minimize VILI.
Signup and view all the flashcards
What are the risks associated with high PEEP?
What are the risks associated with high PEEP?
A high PEEP level (above 12 cmH2O) can increase the risk of complications, such as hemodynamic instability and pneumothorax. These complications are related to the pressure exerted on the lungs and surrounding structures.
Signup and view all the flashcardsStudy Notes
Case 1 Ventilatory Settings
- Patient ventilated with AC-VC, VT 1000 ml, Set Rate = 12 breaths/min, I:E Ratio = 1:2 in constant flow waveform
- Inspiratory flow necessary to achieve settings is 35.71 L/min
Case 2 Patient with Bilateral Pneumonia
- 65-kg IBW man with bilateral pneumonia
- Ventilated on SIMV-VC mode
- VT=500 ml, SIMV rate= 16
- No spontaneous breaths.
- FiO2=0.40, PEEP = 5
- ABG results: pH 7.49, PaCO2 30, PaO2 85
- Action: Decrease RR to 12 breaths/min to achieve desired PaCO2
Case 3 Hyperoxemia
- Patient mechanically ventilated with AC-VC, VT 600, set Rate 12, FiO2 0.65, PEEP 10.
- ABG: pH 7.41, PaCO2 38, PaO2 156
- Action: Decrease FiO2 to 0.38 to achieve desired PaO2
Case 4 Respiratory Alkalosis
- 55-kg IBW adult patient ventilated on SIMV-PC mode
- Set P = 30 cmH2O, exhaled V₁= 660 ml, Rate=12, no spontaneous efforts.
- ABG results: pH=7.55, PaCO2=28, PaO2=87 on FiO2 of 0.45
- Action: Decrease VT to 462 to achieve desired PaCO2
Case 5 Mild Hypoxemia
- Adult patient with bilateral pneumonia ventilated on AC-VC mode
- V₁= 500 ml, Rate=14, FiO2 0.60, PEEP 6 cmH2O
- ABG results: pH=7.41, PaCO2=44, HCO3=25, PaO2=65
- Action: Increase PEEP 2-3 cmH2O
Case 6 Closed Head Injury
- Comatose and apneic patient with closed head injury mechanically ventilated on AC-VC mode
- VT= 600 ml (8 ml/kg), set Rate=10, no spontaneous efforts.
- ABG results: pH=7.39, PaCO2=40, PaO2=108 on FiO2 of 0.30
- Action: No change or decrease FiO2 slightly
Case 7 Respiratory Acidosis and Hypoxemia
- Adult patient (60 kg IBW) ventilated on AC-VC mode
- VT=500 ml, set rate=17, PEEP=12
- Measured PIP= 41, Pplat = 33
- ABG results: pH=7.31, PaCO2=51, PaO2 54, HCO3=22, FiO2=0.60
- Action: Change to AC-PC mode, set appropriate PIP until VT 500ml thereby Pplat. 230, increase RR to 21, increase PEEP 2-3 cmH2O
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
