Mechanical Ventilation - Hemodynamic Devices

mechanical ventilator device

It functions as a substitute for the bellows action of the thoracic cage and diaphragm. It can maintain ventilation automatically for prolonged periods.

volume ventilation

Volume is constant and pressure will vary with the patient's lung compliance.

pressure ventilation

Pressure is constant and volume will vary with the patient's lung compliance.

trigger

The phase variable that initiates the change from exhalation to Inspiration.

limit

The phase variable that maintains Inspiration. It does not end inspiration; it only sustains it.

cycle

The phase variable that ends inspiration.

baseline

The phase variable that controls exhalation.

tidal volume

The volume of gas required for one breath.

FiO2

The oxygen that is delivered to the patient

fraction of inspired oxygen concentration

What does FiO2 mean?

pressure support

It is the positive pressure used to augment the patient's inspiratory efforts.

peep

It is the positive pressure applied at the end of expiration.

positive end-expiratory pressure

What does PEEP mean?

mode

It is the specific operational setting that dictates how the machine interacts with a patient's breathing.

6-10 ml/kg

What is the normal tidal volume range for a mechanical ventilator?

5-10 cm of H20 pressure

What level of pressure support is usually used on a mechanically ventilated patient?

3-5 cm H20

It is the normal PEEP setting for mechanically ventilated patients.

co2 elimination

It is controlled by tidal volume, rate, and dead space.

oxygen tension

It is controlled by oxygen concentration and PEEP.

sterile or distilled water

It is used to warm and humidify inspired gas.

controlled ventilation

The patient receives a fixed level of ventilation and a set number and volume of breaths per minute. It is generally used for patients who are unable to initiate spontaneous breaths.

assist/control

The ventilator's inspiratory cycle is triggered by the patient's breath, delivering a preset volume. It is ideal for patients breathing on their own but at risk of losing respiratory drive or muscle control.

intermittent mandatory ventilation (ivm)

It allows patients to breathe spontaneously at their own rate and volume through the ventilator. It periodically delivers a mandated breath at

a preselected rate and volume or pressure. It is indicated for patients breathing spontaneously but with an inadequate VT or RR.

synchronized intermittent mandatory ventilation (simv)

It allows patients to breathe spontaneously on their own rate and volume through the ventilator. Continuous gas flow supports spontaneous breathing. It is indicated for patients breathing spontaneously but with an inadequate VT or RR.

continuous positive airway pressure (cpap)

It improves oxygenation by elevating end-expiratory pressure for spontaneously breathing patients. For patients with adequate VT but with impaired oxygenation or sleep apnea.

inverse ratio ventilation

It is a volume-targeted mode used in acute respiratory failure. It combines the benefits of a pressure-control mode's decelerating inspiratory flow with the simplicity of volume control. It often requires heavy sedation.

airway pressure release ventilation

It cycle between two different levels of CPAP. The baseline airway pressure is the upper CPAP level, and the pressure is intermittently released. It is used in severe ARDS/acute lung injury.

high frequency ventilation (hfv)

It delivers a small volume of gas at a rapid rate. Indicated for ARDS that is hemodynamically unstable. It requires sedation and pharmacologic paralysis.

60-100 bpm

HFPPV delivers how many bpm?

non-invasive positive pressure ventilation

It uses a nasal or face mask. It delivers air via a volume or pressure-controlled ventilator. Portable and easy to use, suitable for home use.

low-pressure alarm

An alarm that sounds usually due to a leak in the circuit.

high pressure alarm

An alarm that sounds usually due to a blockage in the circuit, patient biting ETT, or mucus plug in the ETT.

to improve secretion clearance and reduce atelectasis

Why is the patient turned from side to side every 2 hours or more?

auscultation of the chest

It is a means of assessing airway patency and ventilator distribution. It also confirms the proper placement of the ET or tracheostomy tube.

mechanical ventilation

It is the process of using an apparatus to facilitate the transport of oxygen and carbon dioxide between the atmosphere and the alveoli for the purpose of enhancing pulmonary gas exchange.

rapid shallow breathing index (rsbi)

It is used to predict the likelihood of successful weaning from mechanical ventilation.

< 105 breaths/min/L

What is the normal range of RSBI?

arterial blood gas (abg)

It acts as a verification tool. It provides critical information about a patient's respiratory and metabolic status.

t-piece

This system provides oxygen enrichment and humidity to a patient with an ET or tracheostomy tube while allowing completely spontaneous respirations.

300 mmHg

A bag of PNSS used as a flush solution (heparinized) with a pressure bag at?

phlebostatic axis

It is a physical reference point on the chest that is used as a baseline for consistent transducer height placement.

cvp monitoring

It refers to the measurement of the pressure within the thoracic vena cava, near the right atrium of the heart. It reflects the pressure in the right atrium, which in turn can be an indicator of the patient's fluid status and right heart function.

right sided cardiac function

It is assessed through the evaluation of CVP.

left sided heart function

It is less accurately reflected by the evaluation of CVP but may be useful in assessing chronic right-and left-sided heart failure and differentiating right and left ventricular infarctions.

internal jugular veins

It is chosen frequently as the site for CVP insertion as there is low incidence of complications such as pneumothorax.

subclavian veins

It is often chosen as the site for CVP insertion due to its recognizable anatomical landmarks.

femoral veins

It is used as the site for CVP insertion as a rapid central access during an emergency.

clabsi

A laboratory-confirmed bloodstream infection not related to an infection at another site that develops within 48 hours of a central line placement.

central line associated bloodstream infection

What does CLABSI mean?

2-8 mmHg or 5-10 cm H2O

What is the normal range for a CVP when taken at the mid-axillary line at the fourth intercostal space?

hemorrhage, catheter occlusion, infection, air embolus and catheter dsiplacement

What are the complications in CVP?

left lateral trendelenburg

If air embolism is suspected in a CVP, the patient must be immediately placed in what position?

pulse oximetry

It is the indirect measurement of oxygen saturation for a patient's vital sign database. It is a simple non-invasive method of monitoring the percentage of hemoglobin (Hb) saturated with oxygen.

oximeter

It is a photo sensor with a light-emitting diode (LED) connected by a cable to an oximeter.

finger, toe, pinna or lobe of ear

What are the typical adult/pediatric sites for monitoring oxygen saturation?

foot or palm and the big toe or thumb

What are the infant sites used for monitoring oxygen saturation?

arterial catheterization

It is a frequent procedure in intensive care settings and the operating room. It is essential for managing critically ill patients who require precise and Continuous monitoring of blood pressure and frequent blood gas analysis.

raynaud syndrome and buerger disease

What are the conditions that increase the risk of complications with arterial cannulation?

radial artery

What is the most common insertion site for arterial catheterization?

modified allen's test

It is used to evaluate collateral circulation prior to cannulating the radial artery.