Mechanical Ventilation pt.2

Definitions

100

Elastance 

The tendency of a structure to return to its original form

200

Ventilation

movement of air into and out of the lungs 

300

Time constant 

The Product of compliance and resistance

400

Internal respiration

Occurs at the cellular level and involves the exchange of oxygen and carbon dioxide between the systemic capillaries and the cells of the body

500

External respiration 

Diffusion of oxygen and carbon dioxide between alveoli and capillaries

Critcal Values

100

MIP

<-20 cmH2O

200

CO2

>50 and rising

300

VC

<10 ml/kg

400

pH

<7.25

500

PaO2

<60 mmHg wile on 21%

Initial Settings

100

Initial Rate for patients with high resistance

8-12 bpm

200

Initial setting for IPAP and EPAP

10-12 cmH20

4-6 cmH20

300

Initial Vt for patients with low compliance

4-6 ml/kg

400

Initial Vt for patients with low compliance

6-8 ml/kg

500

Initial Rate for patients with low compliance

15-25 bpm

ABG

100

pH 7.56 Co2 35 Po2 68 HcO3 30

Uncompensated metabolic acidosis

200

pH 7.24 Co2 58 Po2 52 HcO3 24

Uncompensated resp acidosis

300

pH 7.32 Co2 49 Po2 77 HcO3 24

Uncompensated resp acidosis

400

pH 7.49 Co2 33 Po2 51 HcO3 25

Uncompensated resp alkalosis

500

pH 7.38 Co2 50 Po2 60 HcO3 30

Compensated resp acidosis

Selecting modes

100

Pt is spontaneously breathing and maintaining all normal values.  Currently on PC-CMV, switch them to?

PC-SIMV or VC-SIMV

200

Patient is currently on PC-SIMV and is maintaining all normal

PSV

300

Pt is new onset and sedated

PC-CMV, VC-CMV

400

You want to monitor both Pressure and Volume closely

PVRC or APV or Auto flow

500

Patient is currently sedated on PC-CMV and cannot maintain oxygenation with max Fio2 and PEEP

APRV