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Exam 1 review. PV loop. Note over distention Patient triggers Asynchrony RAW. Flow Patterns. Constant/Square: Causes lower I-time, less MAP, higher PIP Only set in VC Can increase oxygenation Generally uncomfortable for your patients. Flow Patterns. Ramp

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pv loop
PV loop
  • Note over distention
  • Patient triggers
  • Asynchrony
  • RAW
flow patterns
Flow Patterns
  • Constant/Square:
    • Causes lower I-time, less MAP, higher PIP
    • Only set in VC
    • Can increase oxygenation
    • Generally uncomfortable for your patients
flow patterns1
Flow Patterns
  • Ramp
    • Can be set in volume, automatic pattern in PC
    • Will increase MAP, and prolong I-time
    • When switching from constant to ramp, you may have to increase flow to maintain same I-time, I:E ratio
pressure time graph
Pressure time graph
  • Used to assess patient triggering
  • Used to assess inadequate flow rate/double breaths
  • Assess level of PEEP
  • Assess rise time
  • Assess Plat time
work to trigger
Work to Trigger

30

Paw

cmH2O

Sec

1

2

3

4

5

6

-10

slide8

Plateau Time

30

Adequate Plateau Time

Paw

SEC

cmH2O

1

2

3

4

5

6

-20

flow acceleration percent rise time
Flow Acceleration Percent Rise Time

Minimal Pressure Overshoot

P

Slow rise Moderate rise Fast rise

.

V

Pressure Relief

Time

pressure time graph1
Pressure time graph
  • A-B Inspiratory time, B-C Expiratory time, D PEEP level, E PIP
compliance changes
Compliance changes
  • Static vs dynamic
  • Know formula and causes for each
initial setup and manipulation
Initial setup and manipulation
  • Know generic ranges
  • Know modified ranges (VT 5-7 ml/kg with higher rates)
  • Know rules for manipulation
pc vs vc
PC vs VC
  • PC pressure limited time cycled, volume and flow vary, volume varies with compliance, flow varies with minute volume
  • VC volume limited flow cycled, pressure varies with compliance, i-time varies with flow and frictional resistance
simv vs ac vs cpap
SIMV vs AC vs CPAP
  • Know what is set in each mode
  • Know what PSV is and how to set it
formulas
Formulas
  • I:E ratios
  • Desired CO2, PO2 formulas
  • VD/VT ratio
  • A-a gradient, aA ratio, PF ratio
  • VA, VE
  • RAW, CS, CD
auto peep
Auto PEEP
  • How do we fix it?
  • How do we assess it?
slide17
PEEP
  • Indications
  • Uses/hazards
  • Optimal peep
mean airway pressure
Mean Airway Pressure
  • Definition for mean airway pressure (mPaw)
  • Causes for increases MAP
definitions
Definitions
  • Volume assured pressure support
  • ATC
  • PSV
  • AC
  • SIMV
  • CPAP vs PEEP
  • PRVC