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Anesthesiology > Mechanical Ventilation > Flashcards

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

When should the ventilator be set up?

Before the patient is induced.