Discontinuing Vent
Patients who need ventilator support for periods (Greater than 2 weeks) or who have not responded to attempts at ventilator discontinuation
What is Ventilator Dependent?
The best monitoring options provide what?
Detailed, easily interpreted data, obtained noninvasively or minimally invasively with the fewest hazards and side effects
What signals can trigger inspiration?
Volume, Flow, Pressure, Time
NIV includes what?
NPPV and CPAP
What is an advantage to using Volume Control?
More stable minute ventilation that leads to more stable blood gases
What are the common causes of reduced compliance?
Atelectasis, pneumonia, and ARDS
What is your normal rest VO2?
250 ml/min
What is inspiratory pressure?
Pressure is generated either by the patient’s inspiratory muscles (Pmus) or the ventilator (Pvent), which causes an increase in the pressure difference across the respiratory system
The risk of developing nosocomial infections, including VAP is decreased when using?
NIV
“What is set, is what’s delivered”
CMV
P0.1 lower than what indicates increased WOB?
-5 cm H2O
What is the normal range for you VD/VT ratio?
0.20 - 0.40
What are the 4 basic functions of how a ventilator works?
Input power
Power transmission and conversion
Control System
Output (pressure, volume, and flow waveforms)
What is the first-line therapy to treat hypoxemia associated with severe cardiogenic pulmonary edema?
Mask CPAP of 8 to 12 cm H2O and 100% O2
What are some advantages to using Pressure Control?
Better patient synchrony due to varying inspiratory flows
Protects lungs by limiting pressure
Patient comfort
What is a clear reason not to extubate?
Inability to protect or maintain the natural airway is a clear contraindication to extubate
What is the normal range for Airway Resistance?
1 to 2 cm H2O/L/sec
Most modern ICU ventilators are .... powered.
Pneumatically
Restrictive diseases successfully managed with NIV are what?
Postpolio Syndrome, neuromuscular diseases, spinal cord injuries, and severe kyphoscoliosis
What is a hazard of Mechanical Ventilation?
Decreased venous return and cardiac (CO)
After how many months does it take for a patient to be considered permanently ventilator dependent?
They have failed weaning attempts for 3 months
An RBSI less than what indicates the possibility of successful weaning of a patient?
Less than 105
What is the Equation of Motion for the Respiratory System
Pvent + Pmus= elastance x volume + resistance x flow
What are the three types of ventilators are used for NIV?
Noninvasive ventilators
Critical care ventilators
Portable home care ventilators
When should you use an HME?
less than 72-96 hours or during transportation