Flashcards in Mechanical Ventilation Deck (77):
1
Movement of gas in and out of alveoli and defined as the maintenance of normal arterial blood carbon dioxide concentration of 35-45 mmHg is known as what?
Normal ventilation
2
What is eupnea?
Normal respiration
3
What is dyspnea?
Difficult or labored breathing.
4
What is tachypnea?
Excessively rapid respiration.
5
What is bradypnea?
Abnormal slowness of breathing.
6
An abnormal breathing pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing is known as what?
Cheyne-Stokes respiration
7
An abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea is known as what?
Biot's respiration
8
A deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis but also kidney failure is known as what?
Kussmaul breathing
9
An abnormal breathing pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release is known as what?
Apneustic respiration
10
Air in the lungs can be divided into what 4 different volumes?
- Tidal volume
- Inspiratory reserve volume
- Expiratory reserve volume
Residual volume
11
Air in the lungs can be divided into what 4 different capacities?
- Inspiratory capacity
- Functional residual capacity
- Vital capacity
- Total lung capacity
12
Inspiratory capacity is equal to what?
Tidal volume + Inspiratory reserve volume
13
Functional residual capacity is equal to what?
Expiratory reserve volume + Residual volume
14
Vital capacity is equal to what?
Inspiratory reserve volume + Tidal volume + Expiratory reserve volume
15
Total lung capacity is equal to what?
Inspiratory reserve volume + Tidal volume + Expiratory reserve volume + Residual volume
16
What are 2 things that can be measured with a spirometer?
- Tidal volume
- Vital capacity
17
Minute ventilation is equal to what?
Tidal volume x Respiratory frequency
18
What is the minute ventilation of a patient that has a tidal volume of 250 mL and a respiratory rate of 12 bpm?
3,000 mL/mg
19
What can alter the patient's ability to normally ventilate?
Anesthetic drugs
20
What is required for inhalant anesthetics to be properly taken up and eliminated?
Ventilation
21
What can maintain a smooth and stable plane of anesthesia?
Controlled ventilation
22
What is hypercapnia?
Increased level of CO2.
23
What directly causes vasodilation of peripheral arterioles and myocardial depression?
Hypercapnia
24
Hypercapnia can lead to increased intracranial pressure due to what?
Vasodilation
25
Does hypercapnia directly or indirectly increase circulating catecholamines?
Indirectly
26
Narcosis progresses with PaCO2 values above what level?
95 mmHg
27
Complete anesthesia is induced at what level?
245 mmHg
28
IPPV stands for what?
Intermittent positive pressure ventilation
29
IMV stands for what?
Intermittent mandatory ventilation
30
PEEP stands for what?
Positive end-expiratory pressure
31
CPAP stands for what?
Continuous positive airway pressure
32
Positive pressure is maintained only during what?
Inspiration
33
An operator sets a predetermined number of positive breaths, but patient can also breathe spontaneously with what form of ventilation?
Intermittent mandatory ventilation
34
What is applied when positive pressure is maintained between inspirations that are delivered by a ventilator?
Positive end-expiratory pressure
35
Spontaneous breathing with positive pressure during both inspiratory and expiratory cycles is known as what?
Continuous positive airway pressure
36
Closing the pop-off valve and squeezing the reservoir bag until 10-20 cm H2O is reached and then the pop-off valve is reopened so the patient can passively expire is known at what?
Manual intermittent positive pressure ventilation
37
What are 6 reasons a patient might require mechanical ventilation?
- Respiratory center depression
- Inability to adequately expand thorax
- Airway obstruction
- Inability to adequately expand lungs
- Cardiopulmonary arrest
- Pulmonary edema or pulmonary insufficiency
38
Is negative pressure generated during inspiration with mechanical ventilation?
No
39
What might IPPV physically impede?
Venous return to the right side of the heart.
40
The CV effects of mechanical ventilation can be overcome often with what?
Expansion of extracellular fluid volume and administration of inotropic drugs.
41
Excessive or sustained pressure from IPPV can lead to what?
Over expansion and volutrauma.
42
What is tidal volume in small animals?
In large animals?
- 10 to 20 mL/kg
- 15 mL/kg
43
What is inspiratory time for small animals?
For large animals?
- 1 to 1.5 sec
- 1.5 to 3 sec
44
What is the I:E ration for small animals?
For large animals?
- 1:2 to 1:3
- 1:2 to 1:4.5
45
What is the peak inspiratory pressure (PIP) for small animals?
For large animals?
- 15 to 20 cm H2O
- 20 to 30 cm H2O
46
What is the respiratory frequency for dogs?
For cats?
For horses & cows?
For pigs & small ruminants?
- Dogs: 8 to 14 bpm
- Cats: 10 to 14 bpm
- Horses & cows: 6 to 10 bpm
- Pigs & small ruminants: 8 to 12 bpm
47
T/F: The tidal volume for IPPV is usually increase above normal spontaneous tidal volume to compensate for pressure-mediated increases in volume of the breathing system and airway.
True
48
Patients with what 3 conditions may need to have an increased respiratory rate to maintain minute ventilation without creating excessive inspiratory pressures?
- Lung trauma
- Diaphragmatic hernia
- Gastrointestinal distention
49
The amount of gas delivered to a patient depends on several factors including these 2.
- Resistance & compliance of breathing system
- Patient's respiratory system
50
Although inspiratory pressure may not vary over time, what may change as compliance of the respiratory system changes?
Tidal volume
51
A certain level of what is required to stimulate ventilation?
PaCO2
52
If PaCO2 is low, what may not return?
Spontaneous ventilation
53
Opioids, anesthetics, neuromuscular blocking drugs, hypothermia or hypovolemia may have what effect?
Delay return of consciousness and therefore spontaneous ventilation.
54
The patient should continue to receive supplemental O2 and can be manually ventilated at what rate until spontaneous ventilation has returned and stabilized?
1 to 4 bpm
55
What are 3 classifications of ventilator?
- Volume cycled
- Pressure cycled
- Time cycled
56
Which classification of ventilator is the most frequently used in vet medicine?
Time cycled
57
Which type of ventilator inflates lungs to a predetermined volume?
Volume cycled
58
Which type of ventilator inflates lungs to a predetermined pressure?
Pressure cycled
59
The fact that inspiratory pressure may increase if compliance decreases during ventilation is a disadvantage of which ventilator?
Volume cycled
60
The fact that tidal volume delivered may decrease if respiratory compliance decreases in a patient is a disadvantage of which ventilator?
Pressure cycled
61
Which type of ventilator inflates lungs for a preset time at a predetermined gas flow rate?
Time cycled
62
Ascending or "standing" bellows rise during which phase?
Expiratory
63
Descending or "hanging" bellows fall during which phase?
Expiratory
64
With which type of bellow is it easy to detect leaks because because bellows do not return to full height?
Ascending or "standing" bellows
65
Which type of bellow may continue to cycle even with complete disconnection of ventilator from breathing system?
Descending or "hanging" bellows
66
What is an ambu bag used for?
IPPV of small animals with room or supplemental O2
67
What can be inserted on the proximal end of endotracheal tube to deliver IPPV?
Demand valve
68
What is used to re-inflate collapsed alveoli by applying a sustained pressure above normal PIP and using PEEP to prevent derecruitment?
Recruitment maneuver
69
How frequently can a sigh breath be administered?
Once every 5 minutes
70
A large positive pressure breath held for 10-15 seconds is known as what?
Sigh
71
What might be useful to recruit collapsed alveoli and might improve oxygenation?
IPPV
72
What can develop with prolonged exposure to high O2 concentrations?
Oxygen toxicity
73
What are 3 things oxygen toxicity can lead to?
- Pulmonary dysfunction
- Pulmonary edema
- Death
74
What level of oxygen is considered generally safe to administer for prolonged administered?
40 to 50%
75
What needs to be opened at the end of IPPV?
Pop-off valve
76
Maintaining normal ventilation is an important aspect of providing safe general anesthesia since most anesthetized patients do what?
Hypoventilate
77