Mechanical Ventilation in ARDS Patients

<p>90 to 96 percent (D)</p> Signup and view all the answers

<p>40 to 60 L/minute (C)</p> Signup and view all the answers

<p>1:2 to 1:3 (A)</p> Signup and view all the answers

<p>2 L/minute (B)</p> Signup and view all the answers

<p>Applied airway pressure (C)</p> Signup and view all the answers

<p>Delivery of breaths in response to non-patient initiated events. (A)</p> Signup and view all the answers

<p>A shift from routine use to a limited and low-volume approach. (D)</p> Signup and view all the answers

<p>The patient has to generate a greater negative pressure to trigger the machine. (A)</p> Signup and view all the answers

<p>No significant impact on ventilator-free days but a non-significant improvement in 28-day mortality. (B)</p> Signup and view all the answers

<p>Hypotension possibly associated with vasopressor requirements. (C)</p> Signup and view all the answers

<p>90 to 96 percent (C)</p> Signup and view all the answers

<p>It reduces the risk of absorption atelectasis, accentuation of hypercapnia, airway injury, and parenchymal injury. (C)</p> Signup and view all the answers

<p>PaO2 of 55 mmHg and SpO2 of 88 percent (C)</p> Signup and view all the answers

<p>Increased risk of 30-day mortality. (D)</p> Signup and view all the answers

<p>Liberal oxygen strategy is associated with a small but increased hospital mortality. (D)</p> Signup and view all the answers

<p>Carbon monoxide toxicity, cluster headaches, sickle cell crisis (C)</p> Signup and view all the answers

<p>Most oximeters have a standard deviation of +/-2 when compared with measured saturations. (C)</p> Signup and view all the answers

<p>Clinical practice guidelines provide recommendations regarding how to incorporate these data using GRADE frameworks. (B)</p> Signup and view all the answers

<p>PaO2 55 to 90 mmHg (C)</p> Signup and view all the answers

<p>Absorption atelectasis (C)</p> Signup and view all the answers

<p>As SpO2 increased in the liberal strategy group, mortality increased. (B)</p> Signup and view all the answers

<p>Inspiratory time and desired tidal volume (C)</p> Signup and view all the answers

<p>PaO2 &gt; 200 mmHg (D)</p> Signup and view all the answers

<p>1:2 to 1:3 (B)</p> Signup and view all the answers

<p>Maximum limits are unclear and such limits have traditionally not been set. (D)</p> Signup and view all the answers

<p>The set inspiratory pressure, lung compliance, and resistance of the ventilator tubing (B)</p> Signup and view all the answers

<p>4 to 8 mL/kg PBW (D)</p> Signup and view all the answers

<p>There was no significant difference in 30-day mortality between the two strategies. (C)</p> Signup and view all the answers

<p>Oxygenation goals should be individualized and hyperoxia should be avoided. (B)</p> Signup and view all the answers

<p>$30$ cm H2O (A)</p> Signup and view all the answers

<p>To provide additional support for patient comfort and reduce the work of breathing (B)</p> Signup and view all the answers

<p>Achieving a target tidal volume while keeping the respiratory rate below 30 breaths per minute (A)</p> Signup and view all the answers

<p>Tidal Volume (C)</p> Signup and view all the answers

<p>Increased risk of ventilator-associated lung injury (D)</p> Signup and view all the answers

<p>Predicted Body Weight (A)</p> Signup and view all the answers

<p>6 to 8 mL/kg of PBW (C)</p> Signup and view all the answers

<p>It has been shown to improve mortality rates. (D)</p> Signup and view all the answers

<p>Decrease the pressure support (A)</p> Signup and view all the answers

<p>In volume-limited ventilation, tidal volume is constant, whereas in pressure-limited, it is variable. (B)</p> Signup and view all the answers

<p>8 to 10 mL/kg PBW (D)</p> Signup and view all the answers

<p>94 to 98 percent (D)</p> Signup and view all the answers

<p>FiO2 to 1 (A)</p> Signup and view all the answers

<p>90 to 97 percent (D)</p> Signup and view all the answers

<p>55 to 70 mmHg (B)</p> Signup and view all the answers

<p>60 mmHg (D)</p> Signup and view all the answers

<p>All of the above (D)</p> Signup and view all the answers

<p>Lower rates of postoperative pulmonary complications are seen with the LTVV approach. (D)</p> Signup and view all the answers

<p>94 percent (D)</p> Signup and view all the answers

<p>Increasing the tidal volume. (C)</p> Signup and view all the answers

<p>A composite of mortality and/or respiratory complications within 30 days (A)</p> Signup and view all the answers

<p>Atelectasis (C)</p> Signup and view all the answers

<p>Because the true minute ventilation will be determined by the patient's native respiratory rate and actual delivered tidal volume. (D)</p> Signup and view all the answers

<p>The 'less liberal' target SpO2 in the usual oxygen strategy group (A)</p> Signup and view all the answers

<p>The trial was stopped early and effect size may have been exaggerated. (D)</p> Signup and view all the answers

<p>26 breaths per minute. (C)</p> Signup and view all the answers

<p>To facilitate the minute ventilation necessary when using low tidal volumes. (C)</p> Signup and view all the answers

<p>Concerns about mortality differences (D)</p> Signup and view all the answers

<p>Auto-PEEP (B)</p> Signup and view all the answers

<p>Higher severity of illness among the patient population (A)</p> Signup and view all the answers

<p>RR 0.98, 95% CI 0.89-1.09 (C)</p> Signup and view all the answers

<p>Initiate permissive hypercapnic ventilation. (B)</p> Signup and view all the answers

<p>Occurrence of protocol violations and postrandomization exclusions (A)</p> Signup and view all the answers

<p>To mitigate end-expiratory alveolar collapse. (D)</p> Signup and view all the answers

<p>Ventilator Free Days (A)</p> Signup and view all the answers

<p>$5 \text{ cm H}_2\text{O}$ (A)</p> Signup and view all the answers

<p>They can impair cerebral venous outflow. (B)</p> Signup and view all the answers

<p>Patients with barotrauma and a prolonged air leak from pneumothorax. (C)</p> Signup and view all the answers

<p>Insufficient differences between the achieved tidal volumes in the compared groups. (B)</p> Signup and view all the answers

<p>14-22 breaths per minute (B)</p> Signup and view all the answers

<p>To reduce the risk of postoperative pulmonary complications. (B)</p> Signup and view all the answers

<p>60 to 70 L/minute (C)</p> Signup and view all the answers

<p>Dyspnea, spuriously low inspiratory pressures, and scalloping of the inspiratory pressure tracing (D)</p> Signup and view all the answers

<p>It shortens inspiratory time and increases expiratory time, increasing carbon dioxide elimination and improving respiratory acidosis, while also decreasing the likelihood of dynamic hyperinflation (auto-PEEP) and reducing work of breathing (D)</p> Signup and view all the answers

<p>The compliance/resistance of the respiratory system, patient effort, inspiratory pressure limit, and inspiratory time (B)</p> Signup and view all the answers

<p>Ramp wave (decelerating flow) (A)</p> Signup and view all the answers

<p>2 L/minute (D)</p> Signup and view all the answers

<p>The ventilator initiates a breath when the return flow is less than the delivered flow due to the patient's effort. (D)</p> Signup and view all the answers

<p>-1 to -3 cm H2O (D)</p> Signup and view all the answers

<p>Assist control or synchronized intermittent mandatory ventilation (B)</p> Signup and view all the answers

<p>Auto-PEEP (B)</p> Signup and view all the answers

<p>Reduction in absolute overall mortality of the cohort by 6.4 percent (95% CI, 1.9-10.9 percent). (D)</p> Signup and view all the answers

<p>By decreasing the inspiratory time (A)</p> Signup and view all the answers

<p>By distributing ventilation more evenly, particularly when airway obstruction is present (C)</p> Signup and view all the answers

<p>The ventilator will make no changes (B)</p> Signup and view all the answers

<p>The return flow of gas (D)</p> Signup and view all the answers

The volume of air delivered to the patient with each breath; typically set at 6 mL/kg PBW.

The number of breaths delivered by the ventilator per minute; typically set between 12 to 16 breaths/min.

Pressure maintained in the airways at the end of expiration, typically set at 5 cm H2O.

The percentage of oxygen delivered to the patient, targeted to maintain SpO2 between 90-96%.

The rate at which air is delivered to the patient during inhalation, typically 40-60 L/min.

The threshold at which the ventilator responds to the patient's effort to breathe, typically 2 L/min or -1 to -2 cm H2O.

A mode of ventilation where a set tidal volume is delivered with each assisted breath.

A modified ventilation technique that changes airway pressure to achieve a set tidal volume.

A ventilation strategy using a tidal volume of 4-6 mL/kg PBW to minimize lung injury.

Respiratory issues that occur after surgery, often mitigated by lower tidal volumes.

Tidal volume settings during surgery, which can affect patient outcomes.

Lack of variation in tidal volumes can limit the benefits of ventilation strategies.

A condition where air becomes trapped in the lungs due to inadequate expiratory time.

A ventilator strategy allowing elevated CO2 levels to prevent lung injury.

Ventilator settings for Acute Respiratory Distress Syndrome include higher rates and lower tidal volumes.

The process of gradually changing the ventilator rate to meet patient needs.

Adjusting tidal volume helps maintain desired pH and PaCO2 levels in the blood.

Pressure applied to keep alveoli open, generally set at 5 cm H2O.

Can lead to barotrauma and hyperventilation if set too high.

Typically set to provide 80% of total ventilation based on patient breathing rate.

Typically, PEEP can be set as high as 24 cm H2O for ARDS management.

Watching for auto-PEEP in patients to prevent complications during ventilation.

Can cause hypoxemia and atelectasis if PEEP is too low.

The duration for which air is delivered during inhalation, set by clinicians in PRVC.

Ventilation mode where inspiratory pressure is adjusted to achieve desired tidal volume.

Typically set at 6 mL/kg PBW to improve mortality and reduce lung injury.

The maximum pressure in the airways during inhalation, influenced by PEEP and inspiratory pressure.

Mode that combines mandatory breaths with patient-triggered breaths while applying pressure support.

Ventilation mode providing extra pressure for spontaneous breaths without a set rate.

A strategy to use smaller tidal volumes, reducing the risk of lung injury.

Volume set can vary, but often starts around 6-8 mL/kg PBW for most patients.

Tidal volume is based on pressure settings and patient factors like lung compliance.

For ARDS, set between 12 to 25 cm H2O, adjusting for compliance and resistance.

Adding PEEP increases the peak airway pressure, impacting ventilation risks.

Use tidal volumes typically between 6 to 8 mL/kg PBW, avoiding high volumes.

LTVV has been shown to reduce mortality in ARDS patients compared to higher volumes.

Typically set to yield an I:E ratio while allowing spontaneous pressure support.

Avoid using tidal volumes ≥10 mL/kg, as they increase morbidity risks.

Relative contraindications for PEEP during mechanical ventilation.

Individualized oxygenation goals for mechanically ventilated patients.

Avoiding excessive oxygen levels to prevent complications.

The lowest acceptable peripheral arterial saturation for patients.

Fraction of inspired oxygen delivered during ventilation.

Oxygenation limits for patients with high CO2 levels.

Situations that require higher oxygen concentrations.

Potential damage from excessive oxygen levels in medical treatment.

Mortality differences linked to liberal vs conservative oxygen use.

Studies showed no major differences in mortality based on oxygen strategies.

Oxygen management strategies specific to acute stroke patients.

The impact of ventilation strategy on arterial blood gases.

Guidelines for fluid and pharmacotherapy in acute respiratory distress.

Research data covering outcomes in varied critically ill groups.

Recommended lower range of oxygenation for ill patients.

A mismatch between patient effort and ventilator response, often causing discomfort and increased effort.

A deep breath delivered by the ventilator occasionally to maintain lung volume and compliance.

Potential complications from sighs during ventilation, like hypotension and vasopressor need.

A strategy using lower tidal volumes to prevent lung injury during mechanical ventilation.

The likelihood of death within a study population, often expressed as a ratio.

When studies have flaws that can affect the validity of their results.

Fraction of Inspired Oxygen indicating the concentration of oxygen being inhaled.

An approach using higher oxygen levels to treat patients.

Studies where participants are randomly assigned to treatment groups.

Death from any cause within a specified timeframe.

A statistical method that combines results from multiple studies.

A measure of association between exposure and an outcome.

Issues that may lead to treatment being stopped due to risk of harm.

Days a patient spends breathing without mechanical assistance.

The main result measured in a clinical trial.

A protocol to stop a trial early if results are clear or safety is at risk.

A method where participants do not know their treatment to reduce bias.

A measure of the effect of an intervention on the risk of an event occurring over time.

A target oxygen saturation level customized for each patient based on machine learning analysis.

A study that provided data for validating individualized SpO2 targets in the ICU-ROX trial.

A study that externally validated findings from the PILOT trial regarding SpO2 targets.

Individually set SpO2 targets could reduce mortality by 6.4% according to studies.

The speed at which air enters the lungs during inhalation, usually set at 60-70 L/min.

A ventilation mode where the flow of air into the lungs is predetermined during inspiration.

Graphical representation of airway pressure during inspiration, showing scalloping when insufficient flow occurs.

Respiratory conditions causing narrowed airways, increasing the need for higher inspiratory flow rates.

Excess air in the lungs during breathing cycles, often seen in obstructive lung diseases.

A decelerating flow pattern in mechanical ventilation that improves distribution of ventilation.

A method where the ventilator detects a patient's effort through airflow changes to deliver breaths.

A trigger method that starts a ventilator-delivered breath based on detected negative pressure changes.