complete solu on RATED A+ 2025/2026 NEW EDITION
Most important indicator that a pa ent has a severe illness? - Ans Tachypnea
3 respiratory types, and their criteria - Ans Hypoxemic (PaO2 <50-60)
Hypercapnic (PaCO2 >50, pH <7.36)
Mixed
Delta gap (formula, when and why it's used) - Ans Difference in AG from normal - Difference in
HCO3 from normal
In AG metabolic acidosis it's used. It tells you if there's underlying metabolic alkalosis or
respiratory acidosis with bicarb compensa on IN ADDITION to the AG metabolic acidosis. Both
of those would result in a high bicarb to begin with, and a smaller change in bicarb from normal.
Winter's formula (equa on, what it measures) - Ans 1.5[HCO3] + 8 +/- 2
If compensa on is adequate in acid/base issues
How AG changes with albumin changes - Ans Decreases 2.5-3 for every 1 decrease in albumin
Hemodynamic changes a>er intuba on - Ans Hypo/hypertension
Arrhythmia
Tachycardia
Pressure support equa on for BiPAP - Ans IPAP - EPAP
,3 types of vent cycles - Ans Volume (preset dal volume, relieves WOB the most)
Time (constant pressure of me)
Flow (constant pressure un l inspiratory flow is below 25% of peak)
Goal dal volume - Ans 10 cc/kg
Goal FiO2 on vent - Ans Start at 1.0, then decrease as SpO2 tolerates (goal of 92-94 satura on)
Ppeak - Ans Peak inspiratory pressure
Pplat (try to keep it below ?) - Ans Inspiratory plateau pressure (shows alveolar disten on)
30
AutoPEEP (what it is, what it causes, how to fix it) - Ans Breath stacking
Decreases preload to the heart with posi ve pressure on the lungs --> hypotension
Decrease RR, decrease inspira on me (goal is to have more me for the lungs to exhale)
Danger of increased PEEP - Ans Increases autoPEEP, increases Pplat
PaO2 we're usually happy with - Ans >60
When to consider NPPV vs invasive - Ans When it's a quickly solved problem in 1-2 days (e.g.
COPD exacerba on)
When the pa ent can be compliant with working with NPPV
When to consider switching from NPPV to invasive ven la on support - Ans If things aren't
really improving in a maIer of hours
, If your therapeu c goals haven't been met in 4-6 hours
Manual decompression (when you use it) - Ans If pa ent is air trapping like crazy on the vent,
and you disconnect it and push up on the pa ents diaphragm to get everything out
What a high A-a gradient means - Ans V/Q mismatch
Volume assist-control breath (Volume cycled) - Ans Vent delivers preset dal volume
Pressure assist-control breath ( me cycled) - Ans Vent delivers a constant pressure over a
preset me
Pressure support breath (flow cycled) - Ans Same as pressure assist-control breaths, but the
vent cuts out when the flow rate decreases to 25% of ini al peak flow rate
Assist-control ven la on - Ans Either volume or me cycled breaths given
Usually the go to when you just started someone on the vent
Gives the pt a set dal volume and preset flow rate respiratory rate. Very rigid. However, if the
pa ent wants to take extra breaths if they trigger them.
Pressure support ven la on - Ans Waits for pa ent to start breath, and then helps out with a
set amount of pressure
Synchronized intermiIent mandatory ven la on - Ans SIMV
Delivers volume or me cycled breaths at a mandatory rate
Pa ent can breathe spontaneously between mandatory breaths
Spontaneous breaths count - this allows the pa ent to contribute to the mandatory dal
volume the machine requires them to breathe