Mechanical Ventilation Overview
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Mechanical Ventilation Overview

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Questions and Answers

What is the main purpose of pressure support ventilation?

  • To provide inspiratory support and decrease muscle fatigue (correct)
  • To prevent the use of additional oxygen therapy
  • To completely take over all breathing for the patient
  • To assist in the removal of secretions from the airway
  • What does partial ventilator support allow for a patient?

  • Only the ability to breathe in spontaneously without any assistance
  • Spontaneous breaths while receiving ventilator assistance (correct)
  • Ventilator settings that prevent any patient-triggered breaths
  • Complete reliance on the ventilator for all breaths
  • Which of the following would NOT provide an indication for invasive mechanical ventilation?

  • Upper airway obstruction
  • Chronic allergic rhinitis (correct)
  • Risk of aspiration
  • Acute respiratory failure
  • What factors primarily affect the time constant of the lungs?

    <p>Lung elasticity and airway resistance</p> Signup and view all the answers

    Which phase is NOT one of the four phases of a breath during mechanical ventilation?

    <p>Sustaining</p> Signup and view all the answers

    What does CPAP stand for in a medical context?

    <p>Continuous Positive Airway Pressure</p> Signup and view all the answers

    What is a major risk when lowering lung compliance while targeting a return volume in volume control?

    <p>Barotrauma</p> Signup and view all the answers

    What is the primary purpose of mechanical ventilation during spontaneous breathing?

    <p>To assist in preventing alveolar collapse</p> Signup and view all the answers

    Which of the following is NOT a question to consider before starting mechanical ventilation?

    <p>What is the patient's BMI?</p> Signup and view all the answers

    What should be avoided when considering non-invasive ventilation substitution for invasive ventilation?

    <p>Unprotected airway</p> Signup and view all the answers

    What is the Transpulmonary Pressure defined as?

    <p>Difference between alveolar pressure and pleural pressure</p> Signup and view all the answers

    Which of the following is NOT a mode included in mechanical ventilation?

    <p>Continuous Positive Air Channel (CPAC)</p> Signup and view all the answers

    What is the goal of volume-targeted ventilation?

    <p>To ensure adequate tidal volume delivery</p> Signup and view all the answers

    Study Notes

    Mechanical Ventilation

    • CPAP stands for Continuous Positive Airway Pressure.
    • Mechanical ventilation during spontaneous breathing assists patients by providing pressure to prevent alveolar collapse and improve oxygenation.
    • Pressure gradients for pulmonary ventilation are created by air flowing from the higher pressure atmosphere into the lower pressure lungs.
    • When targeting a return volume with lower lung compliance in volume control, risks include barotrauma (lung injury from excessive pressure) and pneumothorax.
    • Non-invasive ventilation is indicated for conditions like COPD and cardiogenic pulmonary edema.
    • The goal of volume-targeted ventilation is to deliver an adequate tidal volume to the patient to provide sufficient ventilation.
    • Before initiating mechanical ventilation, especially invasive ventilation, consider factors such as:
      • Respiratory drive
      • Airway protection
      • Reversibility of respiratory failure
      • Arterial blood gas (ABG) values
      • Lung compliance and resistance
    • Transairway pressure is the difference between airway pressure and alveolar pressure.
    • Transpulmonary pressure is the difference between alveolar pressure and pleural pressure.
    • Transthoracic pressure is the difference between alveolar pressure and body surface pressure.
    • Transrespiratory pressure is the difference between airway pressure and body surface pressure.
    • Mandatory breath preset values include pressure, volume, and time.
    • Alternatives to mechanical ventilation prior to intubation include:
      • Non-invasive ventilation
      • Oxygen therapy (e.g., nasal cannula)
      • Patient positioning
      • Medications
    • Pressure support ventilation can be used with SIMV to decrease work of breathing (WOB) during spontaneous breathing.
    • Non-invasive ventilation should not substitute for invasive ventilation in cases of:
      • Unprotected airway
      • Altered mental status
      • Hemodynamic instability
      • Severe hypoxemia
    • Ventilation modes include:
      • Assist control (AC)
      • Synchronized intermittent mandatory ventilation (SIMV)
      • Continuous positive airway pressure (CPAP)
      • Pressure support (PS)
      • Pressure regulated volume control (PRVC)
      • Volume-limited assist control (VAC)
      • Pressure-limited assist control (PAC)
      • APRV
    • Full ventilatory support involves the ventilator performing 100% of breathing for the patient while maintaining good alveolar ventilation (greater than 8).
    • Pressure support ventilation helps decrease muscle fatigue, provides inspiratory support, and enables patients to breathe spontaneously during mechanical ventilation.
    • BIPAP (Bi-level positive airway pressure) is indicated for conditions like:
      • CHF
      • Pulmonary edema
      • Worsening pneumonia
      • High WOB or respiratory muscle weakness
      • COPD
    • Breaths delivered during mechanical ventilation can be mandatory or spontaneous.
    • Measuring and monitoring compliance during mechanical ventilation is important because it provides information about lung elasticity and helps ensure appropriate settings to prevent lung injury.
    • Partial ventilator support means the patient can take spontaneous breaths while the ventilator assists with respiratory effort.
    • Sensitivity settings can help improve patient effort and prevent asynchrony with the ventilator.
    • The four phases of a breath are:
      • Trigger
      • Limit
      • Cycle
      • Expiratory
    • In pressure-controlled targeted ventilation, patient inspiratory effort affects the volume delivered.
    • Transairway pressure describes the airway movement in conductive airways that generate pressure due to resistance and gas flow.
    • In spontaneous mode, patients can trigger breaths.
    • Advantages of non-invasive ventilation include:
      • Decreased risk of infection
      • Patient comfort
    • Time constants refer to how quickly the lungs can fill and empty, influenced by airway resistance.
    • Indications for invasive mechanical ventilation include:
      • Acute respiratory failure
      • Risk of aspiration
      • Respiratory arrest
      • Myocardial infarction
      • Upper airway obstruction
      • Inability to clear secretions

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    Description

    This quiz covers essential concepts related to mechanical ventilation, including CPAP, pressure gradients, and volume-targeted ventilation strategies. It addresses the clinical implications of mechanical ventilation in various respiratory conditions and outlines factors to consider before initiating treatment.

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