DPT-772: MECHANICAL VENTILATION LECTURE EXAM
QUESTIONS AND ANSWERS VERIFIED LATEST UPDATE
SOLUTIONS
Respiratory Failure Definition
inability of the lungs to provide adequate external respiration
Respiratory Failure means
FAILURE → more like decrease in function
For patients with respiratory failure, there is a need for
mechanical ventilation
Causes of respiratory failure
ventilatory pump failure (musculoskeletal or neuromuscular)
alveolar failure (parenchymal)
circulatory (pulmonary vasculature or cardiogenic)
Respiratory Failure
Indications for mechanical ventilation
Increased PaCO2 >50 mmHg (decreased pH <7.25) not quickly reversible with standard
treatment → placed on noninvasive mechanical ventilation like a CPAP
Decreased PaO2 < 50 mmHg with supplemental O2 use
,Decreased VE (minute ventilation) less than 10 liters/min
Decreased VC (vital capacity) less than 10 liters per min
Decreased inspiratory pressure < 25 cm H2O
Fatigue of ventilatory muscles
Protection of airway
---If someone is very sedated and everything is so relaxed, the patient is unable to keep
your airway open on their own
Consistent respiratory rate of > 30
Acute Ventilatory Failure
Supply and demand mismatch
---The load of what the patient needs and the ventilatory strength that they have
available are not equal
Respiratory Failure
Treatment
Possible attempt at non-invasive ventilation first
Intubation
, Mechanical ventilation
Treatment of problem(s) that caused respiratory failure
Wean from mechanical ventilation
Do not want to keep a patient on a
mechanical ventilator for too long
Even though the patient has a goal to be aggressively weaned from a medical
standpoint, during a session,
the patient needs more support which is an indicator that they cannot handle both the
weaning off of the ventilator and take over the work of breathing plus the physical
demands that you are asking them to do
Requires a conversation with the nurse about weaning at a
slower rate or waiting to wean them after PT consult/treatment
Clinical Objectives of Mechanical Ventilation
Reverse hypoxemia & acute respiratory acidosis
Relieve respiratory distress
Reverse ventilatory muscle fatigue (temporary rest)
Permit sedation, neuromuscular blockade or both
QUESTIONS AND ANSWERS VERIFIED LATEST UPDATE
SOLUTIONS
Respiratory Failure Definition
inability of the lungs to provide adequate external respiration
Respiratory Failure means
FAILURE → more like decrease in function
For patients with respiratory failure, there is a need for
mechanical ventilation
Causes of respiratory failure
ventilatory pump failure (musculoskeletal or neuromuscular)
alveolar failure (parenchymal)
circulatory (pulmonary vasculature or cardiogenic)
Respiratory Failure
Indications for mechanical ventilation
Increased PaCO2 >50 mmHg (decreased pH <7.25) not quickly reversible with standard
treatment → placed on noninvasive mechanical ventilation like a CPAP
Decreased PaO2 < 50 mmHg with supplemental O2 use
,Decreased VE (minute ventilation) less than 10 liters/min
Decreased VC (vital capacity) less than 10 liters per min
Decreased inspiratory pressure < 25 cm H2O
Fatigue of ventilatory muscles
Protection of airway
---If someone is very sedated and everything is so relaxed, the patient is unable to keep
your airway open on their own
Consistent respiratory rate of > 30
Acute Ventilatory Failure
Supply and demand mismatch
---The load of what the patient needs and the ventilatory strength that they have
available are not equal
Respiratory Failure
Treatment
Possible attempt at non-invasive ventilation first
Intubation
, Mechanical ventilation
Treatment of problem(s) that caused respiratory failure
Wean from mechanical ventilation
Do not want to keep a patient on a
mechanical ventilator for too long
Even though the patient has a goal to be aggressively weaned from a medical
standpoint, during a session,
the patient needs more support which is an indicator that they cannot handle both the
weaning off of the ventilator and take over the work of breathing plus the physical
demands that you are asking them to do
Requires a conversation with the nurse about weaning at a
slower rate or waiting to wean them after PT consult/treatment
Clinical Objectives of Mechanical Ventilation
Reverse hypoxemia & acute respiratory acidosis
Relieve respiratory distress
Reverse ventilatory muscle fatigue (temporary rest)
Permit sedation, neuromuscular blockade or both
