PC CMV modes set point and targeting schemes

What do PC CMV modes of Ventilation stand for?

Pressure Control Continuous Mandatory Ventilation.

What is the purpose of the Set Point Targeting Scheme in PC CMV?

To control the pressure at the mouth and limit alveolar pressure.

Name a key outcome for identifying PC CMV modes.

Differentiate a PC CMV mode with set point targeting from a PC CMV mode with adaptive targeting scheme.

What is the control variable in PC-CMV Set Point Targeting Scheme?

Pressure.

What happens to flow and volume in a PC CMV Set Point Targeting Scheme when compliance and resistance change?

Flow and volume will vary.

What are the phase variables in a PC-CMV Set Point Targeting Scheme?

Time cycled, time or patient triggered.

What is the operator's role in the Set Point Targeting Scheme?

To set a driving pressure referred to as pressure control value (PCV).

What does the Adaptive Targeting Scheme in PC CMV aim to deliver?

A target tidal volume.

What is a unique feature of the Adaptive Targeting Scheme compared to the Set Point Targeting Scheme?

The ventilator determines a set point variable independent of the operator.

What type of breath sequence is used in both Set Point and Adaptive Targeting Schemes?

Mandatory breath sequence.

In the PC CMV Set Point Targeting Scheme, what causes the actual respiratory rate to increase?

Patient triggering.

What does PEEP stand for?

Positive End-Expiratory Pressure.

How is flow characterized in PC-CMV Set Point modes?

Flow varies with changes in lung characteristics.

What type of variable may the operator control in PC-CMV Set Point modes?

PCV, Ti, RR, PEEP, FiO2.

What are the waveforms that must be recognized in PC CMV modes?

Pressure, flow and volume vs. time waveforms.

How does the ventilator adapt in the Adaptive Targeting Scheme?

By adjusting the pressure to maintain the desired tidal volume.

What happens if the preset tidal volume cannot be delivered within the upper pressure limit?

Visual and audible alarms are activated.

What does the term 'test breaths' refer to?

The first few breaths used by the ventilator to determine required pressure.

What outcome is expected from maintaining sustained inspiratory pressures in PC CMV modes?

Improving V/Q and oxygenation.

Name a common manufacturer for PC-CMV modes.

MAQUET.

What is the target of the Adaptive Scheme in PC CMV?

Delivering a preset tidal volume regardless of changes in lung mechanics.

What should be monitored in PC-CMV Set Point modes to ensure safety?

Tidal volumes and minute volumes.

What is the significance of the maximum inspiratory pressure?

It is determined by the upper pressure limit set by the operator.

What are some applications of PC CMV Set Point modes?

Recruiting alveoli and ensuring alveolar pressures do not exceed set levels.

What defines the adaptive feature of ventilators in the Adaptive Targeting Scheme?

The ability to adjust pressure based on compliance and resistance changes.

What operator-set parameters are necessary for PC CMV Adaptive modes?

Vt, RR, Ti, Sensitivity, PEEP.

Identify one of the pressure limitations in Adaptive Targeting Scheme.

Upper pressure limit set by the operator.

When the first breath is a volume-targeted test breath, what is measured?

Plateau pressure.

What does a PCV + PEEP calculation represent?

The peak mouth pressure (Pm).

What is Tie?

Inspiratory time.

What are the two targeting schemes for PC CMV?

Set Point and Adaptive.

Describe the response of the ventilator during the Adaptive Targeting Scheme.

The ventilator adapts the pressure to achieve a desired tidal volume.

What is the relationship between resistance and tidal volume in PC CMV Set Point modes?

Resistance changes can lead to variations in tidal volume.

In PC-CMV, what is the significance of flow not being a set point?

Flow can fluctuate based on lung compliance and resistance.

How can alveolar pressures be maintained during inspiration in PC CMV modes?

By sustaining inspiratory pressures.

What is the role of operator sensitivity in PC-CMV Set Point modes?

It allows patient-triggered breaths.

What visualization aids understanding of patient-ventilator interaction in PC CMV?

Pressure, flow and volume waveforms.

What is the pressure control value (PCV) in a ventilation context?

The operator set driving pressure for ventilation.

In what context would alarms be critical during PC-CMV ventilation?

When tidal volumes fluctuate outside safe limits.

What does 'dual control' refer to in the context of PC CMV modes?

Ventilator controlling pressure to deliver volume but maintaining pressure focus.

What should be included in patient monitoring for PC-CMV Adaptive Targeted Modes?

Changes in tidal volume due to compliance/resistance changes.

Why is it important to monitor respiratory rate in PC-CMV?

To ensure sufficient ventilation and oxygenation.

Define the 'cycle variable' in PC-CMV after the breath.

Time.

What happens in the Adaptive Targeting Scheme with changes in lung mechanics?

The ventilator adjusts the pressure to maintain tidal volume.

What is the clinical relevance of understanding compliance and resistance in ventilation?

It helps in managing and adjusting ventilatory support effectively.

What indicates effective ventilation in a patient using PC-CMV?

Appropriate tidal volumes and minute ventilation.

Summarize the purpose of adapting pressure in ventilation.

To ensure that a preset tidal volume is delivered despite changing lung conditions.

What is a feature of time cycled breaths in PC-CMV modes?

They are determined by the set inspiratory time (Ti).

Identify one variable that influences breath initiation in PC-CMV modes.

Time or patient-triggering.

How does sustained positive pressure during inspiration affect ventilation?

It can recruit alveoli and enhance gas exchange.

How does the design of PC-CMV impact patient comfort?

By allowing for patient-triggered breaths and compliance adjustments.

What is the importance of PEEP in PC-CMV modes?

It prevents alveolar collapse and improves oxygenation.

How does increased resistance affect the tidal volume delivered?

It may require higher pressure to maintain the same tidal volume.

What is the concept of 'closed loop control' in adaptive modes?

The system uses feedback from earlier breaths to adjust settings.

Describe how tidal volume can fluctuate in a PC-CMV Set Point mode.

Due to alterations in lung mechanics like compliance and resistance.

In an adaptive scheme, what does the ventilator do if a set tidal volume cannot be achieved?

It adapts the pressure within the set limits.

What parameters define the upper pressure limit?

Operator-set maximum inspiratory pressure.

Why is it crucial for ventilators to adapt during patient movement?

To ensure adequate ventilation despite changing lung conditions.

What can sustained inspiratory pressure provide in terms of ventilation quality?

Improve tidal volume delivery and enhance overall oxygenation.

What happens to the pressure waveform during patient-triggered breaths?

It reflects the pressure delivered to achieve the trigger.

Name an advantage of the adaptive targeting in PC CMV modes.

Maintains tidal volume with variable lung compliance.

What is a primary control element for the operator in PC-CMV modes?

The pressure control value (PCV).

In which scenario might pressure alarms be triggered in PC-CMV modes?

If the pressure exceeds the set limit while trying to achieve tidal volume.

What defines the tidal volume (Vt) in adaptive targeting and control?

A preset volume that the ventilator aims to deliver.

How do visual representations of waveforms aid clinical practice?

They help practitioners assess respiratory mechanics and the effectiveness of ventilation.

What makes pressure targeting unique in the PC-CMV settings?

Pressure remains constant while tidal volumes can vary.

Describe the influence of internal resistances in ventilatory support.

They affect the pressures required to achieve desired tidal volumes.

In what ways are PCV and compliance related?

Higher compliance may reduce the needed PCV to achieve a set tidal volume.

What processes are at play during an adaptive targeting breath?

Adjustment of pressure based on ongoing compliance and resistance data.

What does it mean for a patient if the ventilator alarm sounds due to pressure limits?

The ventilator cannot deliver the set tidal volume safely.

How can the operator adjust ventilation to optimize patient outcomes?

By selecting appropriate parameters like PCV, PEEP, and tidal volume.

What factor is key to successful patient-ventilator synchronization?

The ability for the ventilator to detect patient effort.

Summarize what is monitored in PC CMV to ensure lung protection.

Alveolar pressures, tidal volumes, and minute ventilation.

Why is understanding PC-CMV vital for respiratory therapists?

It enables effective management of ventilatory support for patients.

What does the parameter maximum inspiratory pressure help safeguard against?

Exceeding safe levels of alveolar pressure.

Identify how compliance impacts tidal volume delivery and ventilation.

It influences the amount of pressure needed to maintain a set volume.

Define the characteristics of waveforms produced in PC-CMV modes.

They reflect the pressure, flow, and volume across a time spectrum.

What defines a patient-triggered breath in PC-CMV?

A breath initiated by the patient's inspiratory effort.

What distinguishes PC-CMV from volume control modes?

It focuses on pressure delivery rather than a fixed volume target.

What does a sustained volume ensure during ventilation practices?

Proper gas exchange and adequate ventilation.

What essential aspects must be considered when setting PC-CMV parameters?

Arterial blood gases, patient needs, and lung mechanics.

What variable changes in response to patient effort in an adaptive targeting mode?

Inspiratory pressure.

What are potential consequences of improper ventilator settings in PC CMV?

Risk of inadequate ventilation or barotrauma.

Name the effects of patient compliance on ventilatory strategies.

They affect pressure settings and overall tidal volume delivery.

Explain why real-time monitoring of ventilator parameters is crucial.

To rapidly adapt to patient needs and maintain effective ventilation.

What ensures that ventilator support meets individual patient needs?

Adaptation based on real-time compliance and resistance measurements.

Summarize the effects of resistance in ventilatory support systems.

Higher resistance can require increased pressures to deliver desired volumes.

What physiological principles govern PC CMV operation?

Pressure control, compliance, and resistance.

How can a respiratory therapist ensure optimal ventilation for patients?

By closely monitoring and adjusting ventilatory parameters.

What does a time-cycled breath refer to in PC-CMV contexts?

A breath cycled based on a predetermined inspiratory time.

What importance does PEEP have in maintaining lung function?

Prevents collapse of airways and improves gas exchange.

Identify factors to consider when selecting a PC-CMV mode for a patient.

Lung condition, pressure needs, and volume targets.

How is a constant pressure maintained during PC-CMV?

The ventilator adjusts flow in response to compliance changes.

What visual cues indicate effective patient-ventilator interaction?

Smooth transition of waveforms with no significant disturbances.

Why is the understanding of patient-ventilator interaction fundamental for practitioners?

To institute safe, efficient, and effective ventilatory strategies.

Define the therapeutic goal of PC-CMV Set Point modes.

To ensure adequate ventilation while protecting lung function.

How does tidal volume variation affect minute ventilation in PC-CMV?

Increases in tidal volume translate into higher minute ventilation.

Summarize the role of respiratory therapists in managing PC-CMV.

To assess patient needs and adjust ventilator settings accordingly.

What is essential for monitoring response during high-pressure ventilation?

Continuous observation of patient effort and alarm statuses.

Define the implications of safety limits in PC CMV modes.

They guard against excessive pressure and ensure patient safety.