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mechanical ventillation
RPM II
17
Medical
Graduate
05/26/2010

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Term
what is an iron lung (drinker ventilator)?
Definition
a negative pressure generator (big syringe that pts go in)
Term
what is a cuirass ventilator?
Definition
an iron lung that is fitted to just go over the chest
Term
what are the two types of positive pressure ventilators?
Definition
volume and pressure ventilators (the name tells you what the endpoint of the push is, ie. a volume ventilator will stop at certain volume)
Term
what is the problem with volume ventilators?
Definition
the pressure varies and can be too high/low
Term
what is the problem with pressure ventilators?
Definition
the volume can vary
Term
what is CMV? what are the 2 modes?
Definition
continuous mechanical ventilation of which there are two modes: assist control (breathing rate is constant, but if the pt creates a little negative pressure - the machine instantly provides another breath, *make sure you check what the pt is blowing at, not what the machine is set at*) and control (pt has no control of breathing rate - no one uses this)
Term
what is synchronized intermittent mechanical ventilation (IMV)?
Definition
this is used for getting pts off assist control ventilation and still consists of regulated machine breaths, but in between those, the pt is on their own and can take a breath of whatever volume they want. over time the pt can be *weaned* off the machine breaths.
Term
what is the principle behind CPAP?
Definition
the bigger the gradient between your mouth and the alveoli, the bigger the breath. CPAP creates a higher gradient in pts mouths, allowing pts unable to create normal gradients in their lungs (COPD pts) to take normal breaths. (there is no pushing in CPAP)
Term
what is BiPAP?
Definition
CPAP with a negative expiratory pressure, b/c some pts have a harder time breathing out against CPAP
Term
what is pressure support?
Definition
another weaning mode ventilation machine that some think is better than SIMV. the machine "pushes" air into a pts lungs up to a certain pressure, and then anything thing past that the pt can top off. the main problem with this is the volume may vary. (hydration can decrease lung compliance etc)
Term
what is volume support?
Definition
a *better weaning mode, where the pt triggers a breath and the machine pushes to a preset volume which the pt can then top off
Term
what is the progression of mechanical ventilation types for a pt coming off support?
Definition
control assist -> weaning mode like volume support -> CPAP
Term
what is PEEP?
Definition
positive end expiratory pressure, which keeps more air than usual in your lungs at the end of a breath. this can *help oxygenate pts.
Term
which is longer, inspiration or expiration?
Definition
expiration
Term
how does PEEP help with air trapping?
Definition
if a pt has a diseased lobe and a healthy lobe, most of the air during inspiration goes to the healthy lobe and only a little air may go to the diseased lobe at the end of inspiration. PEEP allows inspiration to last longer and keep the diseased alveoli oxygenated (recruit latent alveoli) and keep the lung from collapsing.
Term
what is an inverse I/E ratio?
Definition
making inspiration last longer, like w/PEEP in order to "recruit latent alveoli"
Term
what is the limiting factor w/inverse I/E ratio?
Definition
a longer inspiration causes more positive pressure which inhibits venous return (increased BP)
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