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