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  1. Initial setting: minute volume
    6-10 L/min
  2. Initial setting: normal tidal volume (the tidal volume is the volume of air that is inhaled or exhaled in a single such breath.)
    10-15ml/kg body weight (less used with h/o COPD or restrictive lung disease)
  3. Initial setting: rate

    varies according to flow rate & what mode is being used
  4. Initial setting: Sensitivity (the amount of inspired effort needed to intiate a breath)
    -1 to -2 cm H2O
  5. Initial setting: flow rate
    40-80 L/min (COPD needs faster flow rate)
  6. Initial setting: PEEP (positive end expiratory pressure)
    5+ to 10+
  7. Pt. has sleep apnea, what ventilator mode or NPPV would you want to put this pt on?
  8. what are some diseases that would qualify patient to have NPPV?
    • *COPD
    • *HF induced Pulmonary edema
    • *Sleep apnea
    • *Neuromuscular (ALS)
    • *Musculoskeletal disorders (muscular dystrophy)
  9. Pt. has lung injury and chronic bronchitis, h/o asthma.
    Basically pt has no breathing capacity
    Pt. needs high flow rates to open lung compartments
    Unnecessary airway pressure should be avoided

    Which vent mode should we put patient on?
    Pressure regulated volume control

    In this mode everything is preset. Inspiratory pressure is delivered at the lowest pressure possible to deliver the full TV/minute volume
  10. Pt. has some but not enough breathing capacity
    Pt.'s ready to be weaned and do not require full ventilation
    Although pt needs breath by breath variations in inspiratory pressure

    Which vent mode should we put pt on?
    Volume support

    this mode initiates every breath. similar to PRVC but no preset TV, flow, rate. Therefore we cannot assess every breath & patient's volumes
  11. Pt. has no breathing capacity
    Pt. has a leakage in the endotracheal tube
    Pt. needs a high initial flow rate to open up closed lung compartments
    Pt. has a lung injury
    Pressure control ventilation

    this mode is similar to A/C or SIMV but pressure controlled not volume controlled
  12. Pt. is paralytics and we do not expect to wean him anytime soon.

    What mode should he be on?
    Assist Control

    This mode has preset rate and tidal volume. ventilator takes over and delivers preset tidal volume
  13. This mode is for patient who has some but not sufficient breathing capacity. It's usually used during weaning. Pt's post-operative
    Synchronous intermittent mandatory ventilation

    PIM- pressure triggered. tidal volume depends on pt's effort

    VIM- if pt does not initiate a breath in 60 sec, ventilator will
  14. Pt has intact respiratory drive
    Pt's with adequate respiratory rates but cannot achieve adequate minute ventilation
    We're weaning off pt
    Pt needs additional monitoring

    What mode should pt be on?
    Pressure support

    Usually used w/ SIMV
  15. What's the first move towards weaning?
    Lowering the FiO2
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