Mechanical Ventilation Lecture Review

Flashcards covering key vocabulary related to mechanical ventilation, including types, modes, settings, physiology of breathing, indications, equipment, complications, and nursing management.

Negative Pressure Ventilation

A type of mechanical ventilation that applies negative pressure to the chest to promote inspiration.

Positive Pressure Ventilation

A type of mechanical ventilation that pushes air into the lungs to create inspiration.

AC/VC (Assist Control/Volume Control)

A ventilator mode where breaths are delivered at a preset volume and rate, or the patient can trigger additional breaths at the preset volume.

SIMV (Synchronized Intermittent Mandatory Ventilation)

A ventilator mode that delivers preset volume breaths synchronized with the patient's effort, allowing the patient to take spontaneous breaths at their own rate and depth in between.

CPAP (Continuous Positive Airway Pressure)

A mode of ventilation that provides constant positive airway pressure throughout the respiratory cycle for spontaneously breathing patients.

PS (Pressure Support)

A ventilator mode that provides a preset amount of inspiratory positive pressure during patient-initiated breaths to decrease the work of breathing, with no set rate or volume.

NPPV (Non-Invasive Positive Pressure Ventilation)

Mechanical ventilation provided without an invasive artificial airway, such as through a mask (e.g., BiPAP).

FiO2

Fraction of Inspired Oxygen; the percentage of oxygen delivered to the patient by the ventilator.

PEEP (Positive End Expiratory Pressure)

A ventilator setting that maintains a positive pressure in the airways at the end of expiration to prevent alveolar collapse and improve oxygenation.

I:E Ratio (Inspiratory:Expiratory Ratio)

The ratio of the time spent in inspiration to the time spent in expiration during mechanical ventilation, typically 1:2 in normal spontaneous breathing.

Intrapleural Pressure

The pressure within the pleural cavity, which is normally negative relative to atmospheric pressure to keep the lungs expanded.

Intraalveolar Pressure

The pressure within the alveoli, which becomes negative during inspiration and positive during expiration.

Ventilation

The movement of oxygen and carbon dioxide in and out of the alveoli.

Diffusion of O2 and CO2

The movement of oxygen and carbon dioxide across membranes at the pulmonary capillaries and cellular level, driven by concentration gradients.

Endotracheal Tube (ETT)

A flexible tube inserted through the mouth or nose into the trachea to maintain an airway, remove secretions, prevent aspiration, and provide mechanical ventilation.

Orotracheal Route

The preferred method for endotracheal intubation, where the ETT is inserted through the mouth.

ETCO2 Detector

A device used to confirm endotracheal tube placement by detecting carbon dioxide in exhaled breath, indicating placement in the trachea rather than the esophagus.

Carina

The point where the trachea divides into the left and right main bronchi; ETT placement is ideally 3-4 cm above this point.

Barotrauma/Volutrauma

Lung injuries caused by excessive inspiratory pressure (barotrauma) or excessive tidal volume (volutrauma) during mechanical ventilation.

Pneumothorax

A potential complication of intubation or mechanical ventilation where air leaks into the space between the lung and chest wall, causing lung collapse.

Tracheostomy

A surgical procedure to create an opening in the trachea to insert a tube, used for long-term mechanical ventilation, frequent suctioning, or bypassing an airway obstruction.

Respiratory Rate (RR)

A ventilator setting that dictates the number of breaths delivered per minute.

Tidal Volume (Vt)

A ventilator setting that dictates the amount of air delivered with each breath, typically 4-6 mL/kg ideal body weight.

Sensitivity (Ventilator Setting)

The amount of patient effort required to initiate gas flow through the circuitry for a patient-initiated breath.

Peak Inspiratory Pressure (PiP)

The maximum pressure that occurs during inspiration, which should ideally not exceed 40 cm H2O to prevent lung injury.

Pressure Control (PC-A/C, PC-IMV)

A ventilator mode where air flows into the lungs until a preset peak inspiratory pressure is reached, with tidal volume varying based on compliance and resistance.

Pressure Regulated Volume Control (PRVC)

A ventilator mode that delivers pressure-limited breaths at a set respiratory rate and a guaranteed set tidal volume, balancing pressure control with volume assurance.

Airway Pressure Release Ventilation (APRV)

A ventilator mode with two levels of continuous positive airway pressure (high and low), allowing unrestricted spontaneous breathing, often used for decreased lung compliance in ARDS.

High Frequency Oscillatory Ventilation

A ventilator mode that delivers super small volumes at a very fast rate (300-420 breaths per minute) to keep alveoli open without causing further damage, often used as a last resort for ARDS.

VAP Bundle (Ventilator-Associated Pneumonia Bundle)

A set of evidence-based interventions to prevent pneumonia in patients on mechanical ventilation, including oral care, HOB elevation, peptic ulcer prophylaxis, DVT prophylaxis, and daily sedation vacations/assessment for extubation readiness.

ABCDEF Bundle

A multi-component bundle for critical care patients, promoting A: assess, prevent, manage pain; B: both spontaneous awakening and breathing trials; C: choice of analgesia and sedation; D: delirium: assess, prevent, manage; E: early mobility and exercise; F: family engagement and empowerment.

Oxygen Toxicity

Lung injury resulting from prolonged exposure to high concentrations of oxygen, potentially causing tracheobronchitis, ARDS, or absorption atelectasis.

Spontaneous Breathing Trial (SBT)

A trial used to identify patients who are likely to succeed or fail liberation from mechanical ventilation, assessing their ability to breathe independently.

Weaning from Mechanical Ventilation

The process where mechanical ventilation support is gradually withdrawn as the patient's respiratory function improves.

High Peak Pressure Alarm

A ventilator alarm that indicates increased airway resistance or decreased lung compliance, caused by factors like anxiety, water in tubing, secretions, kinks, or coughing.

Low Pressure Alarm

A ventilator alarm that indicates a leak or disconnect in the ventilator circuit or from the patient.

Low Exhaled Volume Alarm

A ventilator alarm that indicates insufficient tidal volume returned to the ventilator, suggesting a disconnect, cuff leak, or patient fatigue.

Apnea Alarm

A ventilator alarm triggered when the patient stops breathing or respiratory effort is too low, often due to sedative effects or neurological impairment.