FCCS (FUNDAMENTALS OF CRITICAL CARE
SUPPORT) LATEST WITH COMPLETE SOLUTION |
2024
Pure alpha adrenergic vasopressor - phenylephirine
phenylephirine good in case of - arterial dilat ation without cardiac depression eg
neurogenic shock , hypotention by epidural catheter
epinephrine receptors - alpha and Beta
effect of high epinephrine dose - vasopressor effect
epinephrine desired. effects on heart - potent Inotrope and chronotrope
epinephrine negative effect on heart - Increase oxygen consumption limit the use in
coronary artery disease
vasopressin effect and receptors? - potent vasopressor , V one receptor
vasopressin physiological effect ? - decrease COP , Increase Systemic vascular
Resistance
Vasopressin dose? - 0.0l - 0.04 units/min
what effect has the vasopressin in higher dose ? - Ischemic changes
what are the indications of vasopressin? - . hypotensive shock refractory to other
agents
what are Dobutamine Receptors ? - non selective B adrenergic agonist with Inotropic
effect
What are the hemodynamic changes of Dobutamine? - Increased COP by increasing
stroke volume , BP Remain the same
what patients should be careful with when Introducing dobutamine? - In patients with
Inadequate Intravascular Replacing fluid may cause sudden decrease in BP
what is the physiological effect. of milrinone? - symbathomimetic agent with B
adrenergic-like effect
, Increase coP by increasing stroke V.
and decrease afterload
, Indications for NiPPV ? - ventilation abnormalities
Oxygenation abnormalities
What are ventilation abnormalities to use NPPV ? - _ Respiratory muscle dysfunction
(fatigue , chest wall abn , nuromuscallar disease )
Decrease venitry drive
Increase airway Resistance
What are the oxygenation abnormalities? - Refectory hypoxemia
Net for PEEP
EXV wrk . of Breating
PP. vent other uses - decrease myocardial oxygen cons
. facilitation of alveolar Recruitment to prevent atelectasis
How NPPV workes? - 1. pressure support venti . (IPAP)
2. cont Positive. airway pressure (CPAP) ie EPAP
how much . P ressure allowed. . by NPPV - higher than atmosph pressure and.
functionally equal to PEEP
. What delta P Present in hung volume - tidal volume (atmospheric minus PEEP )
what kind of venti the NPPv provides?. - Patient triggered pressured supp or pt T
Volume cycle
what are Initial set in NPPV ? - Mode : spont
Trigger: maximum sens
Fi o2 : 100%.
EPAP 4-5
1PAP 10-15
Backup Rate 6 Per min
Wt r the contraindications for NPPV? - 1. Severe hypoxemia
2. Arrest
3. MI or arrhythmia
4. Hemodynamic unstable
5. Un cooperative pt
6. Severe encephalopathy
what is the maximum Inspiratory pressure in NPPV ? - 2o. cm H2o. (gastric distention)
when to consider changing from NPPV to invasive ventilation? - l. If No improvement in
1-2hrs
2. If No Relieve of the goal of treatment in the first 4,6 hrs
SUPPORT) LATEST WITH COMPLETE SOLUTION |
2024
Pure alpha adrenergic vasopressor - phenylephirine
phenylephirine good in case of - arterial dilat ation without cardiac depression eg
neurogenic shock , hypotention by epidural catheter
epinephrine receptors - alpha and Beta
effect of high epinephrine dose - vasopressor effect
epinephrine desired. effects on heart - potent Inotrope and chronotrope
epinephrine negative effect on heart - Increase oxygen consumption limit the use in
coronary artery disease
vasopressin effect and receptors? - potent vasopressor , V one receptor
vasopressin physiological effect ? - decrease COP , Increase Systemic vascular
Resistance
Vasopressin dose? - 0.0l - 0.04 units/min
what effect has the vasopressin in higher dose ? - Ischemic changes
what are the indications of vasopressin? - . hypotensive shock refractory to other
agents
what are Dobutamine Receptors ? - non selective B adrenergic agonist with Inotropic
effect
What are the hemodynamic changes of Dobutamine? - Increased COP by increasing
stroke volume , BP Remain the same
what patients should be careful with when Introducing dobutamine? - In patients with
Inadequate Intravascular Replacing fluid may cause sudden decrease in BP
what is the physiological effect. of milrinone? - symbathomimetic agent with B
adrenergic-like effect
, Increase coP by increasing stroke V.
and decrease afterload
, Indications for NiPPV ? - ventilation abnormalities
Oxygenation abnormalities
What are ventilation abnormalities to use NPPV ? - _ Respiratory muscle dysfunction
(fatigue , chest wall abn , nuromuscallar disease )
Decrease venitry drive
Increase airway Resistance
What are the oxygenation abnormalities? - Refectory hypoxemia
Net for PEEP
EXV wrk . of Breating
PP. vent other uses - decrease myocardial oxygen cons
. facilitation of alveolar Recruitment to prevent atelectasis
How NPPV workes? - 1. pressure support venti . (IPAP)
2. cont Positive. airway pressure (CPAP) ie EPAP
how much . P ressure allowed. . by NPPV - higher than atmosph pressure and.
functionally equal to PEEP
. What delta P Present in hung volume - tidal volume (atmospheric minus PEEP )
what kind of venti the NPPv provides?. - Patient triggered pressured supp or pt T
Volume cycle
what are Initial set in NPPV ? - Mode : spont
Trigger: maximum sens
Fi o2 : 100%.
EPAP 4-5
1PAP 10-15
Backup Rate 6 Per min
Wt r the contraindications for NPPV? - 1. Severe hypoxemia
2. Arrest
3. MI or arrhythmia
4. Hemodynamic unstable
5. Un cooperative pt
6. Severe encephalopathy
what is the maximum Inspiratory pressure in NPPV ? - 2o. cm H2o. (gastric distention)
when to consider changing from NPPV to invasive ventilation? - l. If No improvement in
1-2hrs
2. If No Relieve of the goal of treatment in the first 4,6 hrs
