oxygen saturation • Gurgling noise with every breath • Low exhaled tidal volume alarm on ventilator • plateau pressures • peak pressures • pressure or PEEP • PCO2/Respiratory acidosis • Patient discomfort Problems…
compliance (“stiff lung”) plateau pressure; compliance plateau pressure. High plateau pressure increases the risk of barotrauma. Low plateau pressure can result in atelectasis and hypoventilation. Plateau pressure should not exceed…
Tachycardia, tachypnea Change in BP Dyspnea Noisy or shallow ventilation Rhonchi Obvious visible secretions Excessive coughing during inspiratory cycle of ventilator High-pressure alarm on vent Low SaO2 • Instillation of saline/saline…
Acute events overnight • Check vital signs Pulse rate Respiratory rate O2 saturation Blood pressure • Check fluid balance • Examine chest for Air entry Breath sounds Crackles Wheezing • Check endotracheal tube for…
65) have an abnormal swallow • after orotracheal intubation for more than 48 hours Diagnosis • Barium swallow with video fluoroscopy • Esophageal manometry • Endoscopy Treatment • Diet alteration, speech therapy • Temporary gastrostomy Tracheal…
FiO2 by 0.05-.10 increments PEEP by 2–3 cm H2O I:E ratio by changing the inspiratory time (Ti) Suctioning of secretions Use bronchodilators Use diuretics for pulmonary edema High PaO2 (O2…
Plateau >30 cmH2O Peak pressure >40 cmH2O VT > 12–15 ml/kg PEEP >10–15 cmH2O Ventilator-associated pneumonia • Refer to chapter 26 Oxygen toxicity • It is not clear what concentration…
Functional residual capacity Improves gas exchange and oxygenation Redistributes fluid in alveoli FiO2 requirement Helps prevent alveolar collapse Improves lung compliance Minimizes ventilator-induced lung injury Negative Effects Can worsen gas…
Asthma, COPD, ARDS, bronchospasm, trauma • Ventilation-associated High inflation volumes (VT) High minute ventilation (RR) Decreased exhalation time relative to inhalation time (I:E ratio) Anything blocking the exhalation system of the…
Continuous Positive Airway Pressure (CPAP) Bi-level Positive Airway Pressure (BiPAP) • Non-invasive Negative Pressure Ventilation(NINPV) NIPPV It uses a face mask, nasal mask, or helmet mask. It delivers forced air into…
