Mechanical Ventilation Introduction and Management Flashcards

This set of vocabulary flashcards covers essential terms, clinical procedures, and physiological effects related to mechanical ventilation and patient liberation as discussed in the lecture notes.

Decreased Venous Return

A cardiopulmonary effect of mechanical ventilation where high thoracic pressure makes the heart harder to fill, preventing enough blood from returning to the right side.

Fluid Resuscitation

A procedure used when a patient's blood pressure drops due to low volume, involving the rapid administration of fluids, such as a liter of saline or 500 ml at a time.

Hypovolemic

A condition characterized by low blood volume, evidenced in clinical settings when blood pressure returns to normal following a fluid challenge.

Peripheral Vasoconstriction

The mechanism by which blood pressure medications like dopamine, dobutamine, levofed, and norepinephrine work to increase blood pressure by redirecting more blood to the heart.

Trendelenburg Position

A position in which the head of the bed is lowered, used to manage patients with extremely low blood pressure or to assist in traditional chest physical therapy (PT).

Ideal Body Weight

The metric used to determine an appropriate tidal volume for a patient on a mechanical ventilator.

Normal Tidal Volume Range

The standard target range for a healthy patient on a ventilator is $6$ to $8\,ml/kg$ of ideal body weight.

Pressure Support

A ventilator setting used to augment tidal volume and overcome the work of breathing caused by the endotracheal tube in spontaneous mode.

Liberation

The clinical term for discontinuing mechanical ventilation, also commonly referred to as weaning.

RSBI

Rapid Shallow Breathing Index; calculated as the frequency (respiratory rate) divided by the tidal volume ($f/V_T$), with an acceptable score being less than $100$-$105$.

NIF

Negative Inspiratory Force; a test of chest muscle strength indicating a patient's ability to cough, with a goal of at least $-20\,cmH_2O$ or more negative.

Zeep Trial

A weaning trial using zero PEEP and zero pressure support to maximize the challenge to the patient before extubation.

Tube Compensation

A ventilator feature that adjusts the pressure support automatically to overcome the known resistance of a specific endotracheal tube size.

FVC

Forced Vital Capacity; a liberation test where the goal for success is between $10$ and $15\,ml/kg$.

Stridor

A high-pitched inspiratory sound that may occur after extubation due to airway irritation, spasm, or swelling.

Cuff Pressure

The pressure maintained in the endotracheal tube cuff to prevent oral secretions from entering the lungs; acceptable levels are between $20$ to $30\,cmH_2O$ or specifically $25$ to $30\,cmH_2O$.

Chlorhexidine

A drug used in oral care kits to prevent infections, which technically should be administered by a nurse rather than a respiratory therapist.

MLT (Minimal Leak Technique)

A method for inflating a cuff where air is withdrawn until a small leak is heard at the peak of inspiration, and then a small amount of air is added back.

MOV (Minimal Occlusive Volume)

A cuff inflation technique where the cuff is inflated only until the sound of an air leak ceases.

Versed

A type of medication used primarily as a sedative.

Pre-analytical Errors

Mistakes made during the collection or transportation of a blood gas sample, such as allowing air bubbles into the sample, which can compromise the accuracy of results.