ICU & Pulmonary
Card Set Information
ICU & Pulmonary
ICU & Pulmonary cards
Components of ventilator affecting oxygenation? Ventilation?
Oxygenation = PEEP and FiO2
Ventillation = TV and RR
Normal PaO2 based on age? (equation)
PaO2 = 100 - Age/3 (i.e. nml PaO2 for 60y/o = 80)
Stages of COPD severity?
: FEV1 >80% predicted
: FEV1 50-80% predicted
: FEV1 30-50% predicted
: FEV1 <30% predicted
Differential for an anterior mediastinal mass?
Light's criteria for pleural effusions?
Exudative: Protein F:S >0.5; LDH F:S >0.6; LDH >2/3 ULN
What albumin gradient supports exudative vs. transudative in pleural effusions?
Serum Protein Albumin Gradient <1.2 = exudative; >1.2 = transudative
What level of cholesterol in pleural fluid supports exudative vs. transudative?
Exudative = >45; Transudative = <45 (especially if <20)
Initial treatment of chronic cough? (definition of chronic cough?)
Chronic cough = >8wks; Initial: stop ACE-I, stop smoking, CXR; Start flovent 110mcg BID, PPI, & Zyrtec-D x3mo
Common causes of chronic cough?
GERD, upper airway cough syndrome (post-nasal drip), Asthma, non-asthma eosinophilic bronchitis
Most common causes of hemoptysis
bronchitis, lung cancer, pneumonia, TB
Causes of low DLCO with nml spirometry?
Early infiltrative lung disease
PE, pulmonary HTN
CO toxicity (smokers)
How is the DLCO corrected for anemia?
Corrected = DLCO / (Hgb * 0.07)
Name 5 general causes of hypoxia.
1) decreased FiO2 (rare)
2) Altitude (decreased barometric pressure)
4) V/Q Mismatch and decreased diffusion
How can you determine what the cause of hypoxia is (algorithm)?
: A-a gradient.
-- If nml = hypoventilation or altitude/dec FiO2
-- If elevated, see if hypoxia is corrected by supplemental oxygen
* If corrected by oxygen = V/Q mismatch
* If NOT corrected by supplemental oxygen = Shunt
A-a gradient equation? (condensed) Nml?
[150 - (PaCO2/0.8)] - PaO2 = A-a gradient
Nml = 10-15 (adj for age: 2.5 + 0.2*Age)
How do you adjut BiPap settings to improve oxygenation & ventilation?
IPAP = CO2
EPAP = PEEP = Oxygen
Increase IPAP to decrease CO2
Increase EPAP to increase oxygen
**keep at least a gradient of 4 between EPAP & IPAP