Initial Settings in Mechanical Vent

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Anonymous
ID:
266843
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Initial Settings in Mechanical Vent
Updated:
2014-03-17 21:29:18
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initial settings mechanical vent
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initial settings in Mechanical Ventilation
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  1. name 4 modes the positive pressure ventilator includes
    • 1. CMV - assist control 
    • 2. IMV - SIMV 
    • 3. Assist - PSV 
    • 4. CSV - Spontaneous - CPAP
  2. positive pressure ventilation may be ... controlled or ... controlled
    volume (cycled) or pressure (cycled)
  3. most common type for ventilating adults
    volume ventilation
  4. allows operator to set certain parameters
    volume ventilation
  5. Name 3 parameters of volume ventilation
    • 1. volume delivered (tidal volume, minute volume) 
    • 2. rate 
    • 3. flow
  6. volume ventilation guarantees delivery of a certain volume regardless of ...
    lung characteristics
  7. Name a complication of volume ventilation
    barotrauma (pressure will rise)
  8. Name the 3 factors that affect pressure levels in volume ventilation
    • 1. patient lung characteristics 
    • 2. inspiratory flow pattern 
    • 3. volume setting
  9. what is the goal of any type of ventilation?
    provide minute volume adequate to maintain physiologically acceptable levels of ventilation (ABG)
  10. the desired minute volume is based on ...
    the size of the patient & then adjusted for metabolic rate
  11. Name the formula for minute volume in a man & woman
    • man: 4 x BSA 
    • woman: 3.5 x BSA
  12. BSA is determined by a ... which takes height, weight, & a constant into effect
    nomogram
  13. increases in metabolic rate require ...
    increases in minute volume
  14. increases by ... per degree C above 37
    9%
  15. add ... for every 2000 ft elevation above sea level
    5%
  16. add ... for metabolic acidosis
    20%
  17. desired tidal volume is based on ... & ...
    gender & ideal body weight
  18. Name formula for IBW for man & woman
    • man: 106 + 6 (ht in inches - 60) / 2.2 
    • woman: 105 + 5 (ht in inches - 60) / 2.2
  19. IBW in kg is multiplied by a volume of ... to determine the tidal volume
    7 ml/kg
  20. what normal tidal volume will we use for initial settings?
    7 ml/kg
  21. what tidal volume is used in ARDS patients?
    4-8 ml/kg
  22. what tidal volume is used in COPD patients?
    6-8 ml/kg
  23. tidal volumes should be adjusted based on measurement of ... & ...
    plateau pressure & auto PEEP
  24. ... is permitted to avoid lung injury
    permissive hypercapnia
  25. remember to add the amount of ... if it is not automatically adjusted by the ventilator
    tubing compliance
  26. initial respiratory rate should be set between ...
    8-20 bpm
  27. ... & ... are often adjusted for the patients lung characteristics
    respiratory rate & volume
  28. flow rate should be fast enough to deliver the breath in the desired time to achieve an I:E ratio of between ...
    1:1.5 to 1:4
  29. flow must meet patients inspiratory demands or ...
    WOB increases
  30. fast flows shorten ... & ... which can help COPD patients or patients with high resistance
    I time & lengthen expiration
  31. slower flows improve ... & ... with lower pressure that help with ARDS patient
    gas distribution & improve oxygenation
  32. Name the 4 flow patterns
    • 1. constant flow 
    • 2. ascending ramp 
    • 3. sine wave 
    • 4. descending ramp
  33. provides flow of gas at set value through out the breath
    constant flow (square wave)
  34. flow rises instantly to set rate & maintained there until breath ends
    constant flow
  35. constant flow results in a ...
    higher peak pressure
  36. flow starts low & accelerate reaching peak at end inspiration
    ascending ramp
  37. flow & pressure are highest in the middle & lower at both the start & end of the breath
    sine wave
  38. more like a spontaneous breath
    sine wave
  39. opposite of the way people breathe naturally
    ascending ramp
  40. in sine wave, peak pressures are ... than other modes, especially when resistance is high
    higher
  41. most commonly used flow pattern
    descending ramp
  42. produces lowest amount of patient effort & WOB. Flow is highest initially & declines as breath goes in
    descending ramp
  43. descending pattern improves ... within the lung & reduces ... & increases oxygenation
    gas distribution & reduces dead space
  44. ... don't always result in high alveolar pressures
    high PIP
  45. average pressure in the lung throughout the entire breath
    mean pressure
  46. is mean pressure is high this means ...
    high pressure is applied to lung tissue for a longer time & increases chance of pressure injury
  47. in low compliance patients with hypoxemia, descending pattern will keep peak pressures ... & ...
    lower & improve gas distribution
  48. in patients with high Raw, the descending pattern will deliver the volume with a ... & ...
    lower pressure & better distribution
  49. provides a set pressure & delivered volume varies based on patient lung characteristics
    pressure ventilation
  50. pressure ventilation can either be ... or ...
    pressure control & pressure support

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