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Tech III

Module II, Chapter 50 Noninvasive Positive Pressure Ventilation

QuestionAnswer
Any mode of ventilatory support using positive pressure that is provided WITHOUT endotracheal intubation or tracheostomy. Noninvasive pressure ventilation (NPV)
Method of respiratory assistance based on intermittent application of sub atmospheric pressure external to the chest wall through a tank. negative pressure assisted ventilation (NAPV)
Respiratory assistance based on application of distending flow via an external interface to attain a defined constant positive pressure. CPAP
How does CPAP reduce V/Q mismatch? by improving FRC and reducing intrapulmonary shunting.
True or False. CPAP is a good choice when the patient's primary problem is hypoxemia, but the patient has adequate ventilation. TRUE
A means of respiratory assistance that utilizes a soft nasal cannula interface and high humidified slow source to raise intraluminal pharyngeal pressure. high-flow nasal cannula (HFNC)
What is the goal of using the HFNC? to administer a threshold level of nasal gas flow to raise the intraluminal nasopharyngeal pressure enough to maintain upper airway patency and increase the FRC
What are some indications for NIV? 1. patients with acute-on-chronic respiratory failure for short-term ventilation 2. terminally ill patients who do not wish to be intubated 3. tolerate the nasal or mask interface of long-term ventilation 4. patients with acute respiratory failure
What are some CONTRAINDICATIONS for NIV? 1. DNR 2. patients who are unable to clear secretions 3. inability to fit a mask 4. respiratory arrest or need for immediate intubation 5. severe acidosis
CONTRAINDICATIONS for NIV. (2) 6. shock or systolic pressure < 90 torr 7. uncontrolled arrhythmias 8. uncooperative patient 9. upper airway obstruction or trauma
NIV has been found to reduction rates of intubation and mortality in patients with acute _____ _____ _____. cardiogenic pulmonary edema
How does NIV reduce rates of intubation and mortality in patients with acute cardiogenic pulmonary edema? NIV reduces venous return (preload) and left ventricular afterload---thus reducing the workload on the weakened left heart.
NIV has been found to be largely ineffective in patients with stable, but severe _____. COPD
What are some of the objectives of NIV in acute settings? to avoid intubation, to improve gas exchange, to decrease mortality, to decrease the length of time on ventilation, to decrease length of hospitalization, maximize patient comfort
What are some of the objectives of NIV in long-term settings? to relieve or improve settings, to enhance quality of life, to avoid hospitalization, to increase survival, to improve mobility
NIV with negative pressure involves applying _____ pressure intermittently through a curass or tank device external to the chest wall. subatomic pressure
NIV with negative pressure involves applying subatomic pressure intermittently through a _____ or a tank device external to the chest wall. curass
One advantage of NIV with negative pressure is that it can improve elimination of _____ without a tracheostomy. CO2
In NIV with negative pressure, to raise the tidal volume, what should happen to the subatomic pressure? it should be decreased in increments
NIV Noninvasive ventilator
NPV negative pressure ventilator
RIP respiratory impedance (apnea monitor)
ARF acute respiratory failure
In critically ill patients with acute respiratory failure, NIV is attempted to prevent _____. intubation
In what environment are NPV's most often used? in the home environment
NPV's can maintain adequate gas exchange in patients who are _____. hypoventilating (particularly at night)
In what settings are NIV's used? (stable patients) sleep lab, outpatient setting
Created by: Respiratory22
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