Non-Invasive Positive Pressure Ventilation Exam Questions and Answers Latest Version

Non-Invasive Positive Pressure Ventilation Exam Questions and Answers Latest Version Define the following terms/abbervations: NPPV, CPAP, BiPAP, IPAP, EPAP, PSV, and PEEP. - Answers NPPV - Ventilation w/o an artificial airway CPAP - Provides + airway pressure during an entire spontaneous breath along with PEEP (or elevate baselines) BiPAP - 2 level pressure vent mode - IPAP and EPAP IPAP (pressure support) - Supports the patient's inspiratory effort - Increase Vt*, Ve, and decrease CO2 - Improves ventilation - Patient triggered, pressure limit, and flow cycled EPAP - Expiratory + airway pressure - Increases PaO2 PSV - Pressure support ventilation -Ex. PSV = 5 cm H20 ---> 10/5 PEEP - + pressure breaths at end exhalation - > FRC and alveolar expansion Explain rationale for initial setting and titration of IPAP and EPAP. - Answers For COPD pts w/ air trapping, EPAP is set at 80-90% of auto-peep and PEEP at 3-10 cm H20. - Initial settings are set to treat the patient's current respiratory condition first (hypoxemia, resp distress, etc.) and then assess for no more signs of accessory muscle usage (sternoclediomastoid) to titrate down on EPAP. Define OSA - Answers - Obstructive sleep apnea - A condition in which the tongue and soft palate collapse, causing airway obstruction during nocturnal sleep. Define the following terms, apnea index, hypopnea, desaturation index. - Answers Apnea index - Index used to indicate the severity of sleep apnea. Hypopnea - Abnormally slow or shallow breathing. Desaturation index- Amount of times per hr of sleep that a patient's PaO2 drops by a certain degree from baseline. List the indications and contraindications for CPAP. - Answers CPAP indications - Bilateral infiltrates on CXR - Recurrent atelectasis w/ low FRC - Reduced Cl - PaO2 < 60 mmHg on FiO2 50% - PaO2/FiO2 < 300 for ARDS - Refractory hypoxemia: PaO2 increases <10 mm Hg w/ FiO2 increase of 0.2 Contraindications - Persistent episodes of desaturation or bradycardia - Unable to maintain PaCO2 < 60 and pH > 7.25 - T-E fistula - Infants w/ NMD Compare and contrast CPAP and BiPAP - Answers CPAP - The patient is spontaneously breathing receiving + airway pressure and PEEP throughout a whole respiratory cycle. BiPAP - 2 pressure level mode (IPAP/EPAP)