PC CMV modes set point and adaptive targeting schemes

What are the two types of targeting schemes in PC CMV modes of ventilation?

Set Point Targeting Scheme and Adaptive Targeting Scheme.

What is the control variable in PC CMV modes?

Pressure.

What is the breath sequence in PC CMV modes?

Mandatory.

What are the phase variables in PC CMV modes?

Time cycled, time or patient triggered.

What is the limit variable in PC CMV modes?

Pressure.

What is a key characteristic of the Set Point Targeting Scheme in PC CMV?

Constant pressure creates an exponential flow decay pattern.

How is the pressure determined in the Adaptive Targeting Scheme?

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

What happens to flow and volume in a PC CMV mode with Set Point Targeting?

Flow and volume vary with changes in compliance and resistance.

What can cause an increase in the actual respiratory rate in a PC CMV mode?

Patient triggering.

What parameters are set for a PC CMV Set Point mode?

Pressure Control Value (PCV), Ti, RR, PEEP, FiO2, and sensitivity.

What is the main goal of the PC CMV Set Point Targeted Modes?

To ensure that alveolar pressures cannot exceed the set pressure control level.

What is a key application of PC CMV Set Point Targeted Modes?

Monitor tidal volumes and minute volumes with alarms.

What does the Adaptive Targeting Scheme aim to maintain?

The pre-set tidal volume.

In Adaptive Targeting Schemes, how does the ventilator respond to changes in lung characteristics?

It adjusts the pressure to maintain the desired volume.

What are the first few breaths in the Adaptive Targeting Scheme considered as?

Test breaths.

What type of mode is Pressure Regulated Volume Control Mode (PRVC)?

A type of PC CMV Adaptive mode.

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

Visual and audible alarms are activated.

What effect does sustained inspiratory pressure have on alveoli?

It can recruit alveoli and improve ventilation/perfusion (V/Q) and oxygenation.

What is the effect on tidal volume and minute volume when a patient triggers mandatory breaths in PC CMV?

Both tidal volume and minute volume will increase.

What is defined as the sum of Pressure Control Value (PCV) plus PEEP?

Peak pressure (Ppeak).

What is the condition for flow in the Set Point Targeting Scheme?

Flow is not a set point; it varies with lung characteristics.

In what conditions may waveforms be analyzed in PC CMV modes?

Pressure, flow, and volume vs. time.

What is the inspiration time (Ti)?

The time set by the operator for the cycle variable.

What could occur if the airway pressure exceeds the set pressure control level?

Alarms will be triggered.

What is the significance of the upper pressure limit in Adaptive Targeting?

It prevents excessive pressure while delivering the set tidal volume.

In the context of PC CMV modes, what does PEEP stand for?

Positive End Expiratory Pressure.

What happens during expiration in PC CMV modes?

The ventilator stops delivering pressure and allows passive expiration.

What is the role of the operator in the Set Point Targeting Scheme?

To set the driving pressure, or pressure control value (PCV).

What variable is dynamically controlled by the ventilator in Adaptive Targeting?

Pressure to achieve the desired tidal volume.

In PC CMV modes, what does the term 'mandatory' refer to?

Breaths that are mandatory and delivered by the ventilator regardless of patient effort.

In terms of waveform analysis, what does a tidal volume waveform represent?

The volume of air delivered during each breath.

How does the ventilator ensure consistent tidal volumes in the Adaptive Targeting Scheme?

By adapting pressure in response to changes in lung compliance and resistance.

What type of patient characteristic does the ventilator in Adaptive Targeting respond to?

Changes in compliance and resistance.

How does the Adaptive Targeting Scheme affect patient comfort?

It can improve comfort by better matching delivered ventilation to patient needs.

In PC CMV Set Point modes, what does the flow pattern look like?

An exponential flow decay pattern.

What is the relationship between compliance and flow in the Set Point Targeting Scheme?

Flow will vary inversely with compliance.

What does PCV stand for?

Pressure Control Ventilation.

How is the pressure delivered during the Adaptive Targeting phase?

In response to the real-time feedback from compliance, pressure, and volume measurements.

Identify a common manufacturer name for PC CMV modes.

Examples include Maquet and Servo.

What is the consequence of improper setting of tidal volume?

It may lead to inadequate ventilation or over-distension.

Why is it important to monitor alarms in PC CMV modes?

To ensure safe ventilation and prompt responses to changes.

What is the difference between Set Point and Adaptive Targeting in terms of control?

Set Point is operator-defined while Adaptive is determined by the ventilator.

What happens to the pressure during inspiration in the Set Point Targeting Scheme?

It remains constant regardless of patient lung compliance changes.

In Adaptive modes, what does the ventilator adjust to compensate for ventilation needs?

Inspiratory pressure.

What are the two key waveforms analyzed during PC-CMV ventilation?

Pressure waveform and flow waveform.

What does the term 'peak pressure' refer to in the context of PC-CMV?

The maximum airway pressure reached during inspiration.

What is the purpose of the PEEP in PC CMV modes?

To maintain open alveoli at the end of expiration.

What must be done if the measured exhaled tidal volume is significantly lower than set?

Adjust settings or evaluate patient condition.

What does Ti refer to in ventilator settings?

Inspiratory time.

What is the significance of controlling pressure at the mouth in ventilation?

It limits the size of the alveolar pressure.

What does the term 'dual control' imply in the context of Adaptive Targeting?

The ventilator aims for a tidal volume while controlling pressure.

What does an increase in Paw indicate in the use of ventilators?

Possibly improved recruitment of collapsed alveoli.

What is the function of the operator during the Adaptive Targeting Scheme?

To set the desired tidal volume.

What are the potential risks associated with high-pressure settings on the ventilator?

Lung over-distension and barotrauma.

What is indicated by the abbreviation O2 in the context of ventilator settings?

Oxygen concentration.

What happens if compliance drops suddenly during ventilation?

The ventilator must increase pressure to maintain tidal volume.

What parameter must be considered when setting ventilator alarms?

Tidal volumes and minute ventilation.

How many modes can PC CMV be classified into based on targeting?

Two: Set Point and Adaptive.

What can affect the needed pressure setting in Adaptive Targeting Schemes?

Changes in lung mechanics over time.

What does the term 'sensitivity' refer to in ventilator settings?

The responsiveness of the ventilator to patient-triggered breaths.

Why should clinicians be familiar with both PC CMV targeting schemes?

To optimize individualized patient ventilation strategies.

What factors can lead to false readings in ventilator measurements?

Equipment malfunctions or improper connections.

In PC-CMV, how is the operator able to provide full support to the patient?

By programming mandatory breaths.

What is a significant downside of only using Set Point Targeting?

It may not adapt well to sudden changes in patient needs.

What does V/Q refer to in the context of ventilation?

Ventilation/perfusion ratio.

How does the pressure of the ventilator contribute to lung recruitment?

By providing sustained inspiratory pressures.

What is a primary concern when monitoring PC-CMV modes?

Ensuring that patient safety is prioritized through alarms.

What happens to the respiratory rate if compliance decreases unexpectedly?

The ventilator may increase pressure but the patient’s work may also increase.

What does the acronym FiO2 stand for?

Fraction of Inspired Oxygen.

What is key when interpreting waveforms in PC CMV modes?

Understanding the relationship between pressure, flow, and volume.

What should be monitored if a patient is exhibiting increased work of breathing?

Ventilator settings and patient response.

What is the benefit of using both pressure and volume control features in a ventilator?

To optimize ventilation according to the patient’s needs.

How does the Adaptive Scheme enhance patient-ventilator synchrony?

By adjusting pressure delivery based on real-time feedback.

In PC CMV, what phase occurs once the inspiratory phase ends?

The expiratory phase begins.

What happens when a patient triggers breaths without adequate settings?

It may result in inadequate ventilation or compromised gas exchange.

What does the abbreviation RR stand for in ventilator settings?

Respiratory Rate.

What are the effects of increasing PEEP?

Can improve oxygenation but may decrease venous return.

What type of patient may benefit from PC-CMV?

Patients with high respiratory demand or limited ability to breathe spontaneously.

Why might clinicians choose the Adaptive Scheme over Set Point?

For more responsive ventilation to changing lung conditions.

What does a pressure waveform typically show?

The pressure changes during the inspiratory phase.

Why are test breaths performed at the beginning of Adaptive Targeting?

To gather baseline compliance, pressure, and volume measurements.

How does the PC-CMV system ensure consistent tidal volume delivery?

By adjusting the pressure as needed during ventilation.

What is a potential outcome of inadequate monitoring in ventilated patients?

Severe hypoxemia or hypercapnia.

What can cause the ventilator to transition from pressure control to volume control?

Changes in patient mechanics or settings.

What is the role of alarms in the PC-CMV system?

To alert clinicians of potential hazards or settings deviations.

How do you interpret a spike in the pressure waveform?

It may indicate a change in patient effort or compliance issues.

What parameter should be set to allow patient-triggered breaths?

Sensitivity.

What can excessive airway pressure lead to during ventilation?

Potential lung injury or ventilator-induced lung injury (VILI).

In terms of compliance, what does the ventilator need to adjust to maintain target volumes?

The pressure level.

What is a common parameter seen in both PC CMV targeting schemes?

Tidal Volume (Vt) settings.

Which targeting scheme provides no room for patient variability?

Set Point Targeting Scheme.

What does a flow waveform demonstrate during inspiration?

The pattern and volume of air delivered.

What is crucial when interpreting time-volume curves?

Understanding how the patient interacts with ventilator settings.

What is one distinct feature of the Adaptive Targeting scheme?

It allows for real-time adjustments by the ventilator to maintain set volumes.

What are the consequences of a poorly set inspiratory time?

Inadequate gas exchange or patient discomfort.

Why is it important to understand both set point and adaptive targeting?

To effectively manage patient ventilation strategies.

How does the PC CMV mode handle varying lung compliance in real-time?

By dynamically adjusting inspiratory pressure to maintain volume delivery.

What can excessive minute volumes indicate about ventilation?

A potential over-ventilation or hyperventilation.

What must be monitored closely to ensure patient safety during PC-CMV?

Ventilator settings and any alarms.

What adaptation does the Adaptive Scheme perform if the set tidal volume is compromised?

It adjusts pressure accordingly to achieve the necessary volume.