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Differentiate between Type 1 and Type 2 respiratory failure.
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Type 1 respiratory failure is hypoxemic, involving low blood oxygen, whereas Type 2 is hypercapnic, indicating ventilatory failure with difficulty moving air in and out.
How does the Assist Control (CMV) ventilator mode function?
Assist Control provides full ventilatory support by delivering preset tidal volumes and respiratory rates, regardless of patient effort.
What is the significance of inline suctioning in ventilated patients?
Inline suctioning is performed to maintain appropriate PEEP levels and ensure the airways remain clear.
What are the primary functions of the alveoli in gas exchange?
The alveoli are responsible for inhaling oxygen into the blood and exhaling carbon dioxide out of the blood.
What roles do sedation and neuromuscular blockers play in the management of ARDS?
Sedation helps ease patient discomfort and improve mechanical ventilation synchrony, while neuromuscular blockers prevent patient movement and high demand breathing.
Discuss the importance of 'Three P's' in the management of ARDS.
The 'Three P's'—prone positioning, PEEP, and permissive hypercapnia—are strategies used to optimize oxygenation and reduce lung injury.
What are common signs of hypoxemic respiratory failure?
Common signs include shortness of breath, high respiratory rate, low O2 saturation, and altered mental status.
Identify complications associated with mechanical ventilation and their causes.
Complications include barotrauma from high pressures and ventilator alarms, such as low pressure (indicating leaks) and high pressure (indicating obstructions).
Explain the mechanism of pulmonary shunting and its impact in respiratory failure.
Pulmonary shunting occurs when the lungs constrict in response to hypoxia, affecting oxygen application and preventing oxygen from reaching the lungs.
How is the normal VQ ratio defined and what abnormalities can occur?
The normal VQ ratio is 0.8 to 1.2. Abnormalities include shunting (perfusion without ventilation) and dead space (ventilation without perfusion).
Describe the three phases of ARDS and their characteristics.
Exudative: Fluid leakage into alveoli. Proliferative: Continued inflammation. Fibrotic: Development of lung fibrosis.
Why is PEEP particularly increased in cases of ARDS?
In ARDS, higher PEEP is used to keep alveoli open and improve oxygenation despite the high permeability and inflammation in the lungs.
What PaO2 levels define mild, moderate, and severe hypoxemia?
Mild hypoxemia: PaO2 60-79 mmHg. Moderate: 45-59 mmHg. Severe: <45 mmHg.
Why is it crucial to maintain mean arterial pressure above 65 mmHg in respiratory failure patients?
Maintaining mean arterial pressure above 65 mmHg ensures adequate perfusion and oxygen delivery to vital organs, preventing further complications.
List the typical settings for mechanical ventilation in treating hypoxemic patients.
Respiratory rate: 12-20 breaths/min. Tidal volume: 6-8 mL/kg. FiO2: adjusted to keep O2 levels 60-80. PEEP: usually 5, higher in ARDS.
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