Non-Invasive Positive-Pressure Ventilation
Exam Questions And Answers
NPPV - ANS noninvasive positive pressure ventilation
bilevel positive airway pressure (BiPAP) - ANS noninvasive ventilation device like a CPAP
machine; however, it can be set at a higher pressure for inhaling and a lower pressure for
exhaling. IPAP AND EPAP!!!
continuous positive airway pressure (CPAP) - ANS a form of noninvasive positive pressure
ventilation (NPPV) consisting of a mask and a means of blowing oxygen or air into the mask to
prevent airway collapse or to help alleviate difficulty breathing
Definition of noninvasive positive-pressure ventilation - ANS The application of positive
pressure via the upper respiratory tract to augment alveolar ventilation.
What is NPPV used for? - ANS To provide improved alveolar ventilation to those patients in
acute respiratory failure, especially when intubation is not desirable
What interfaces are used with NPPV? - ANS -Nasal or full face mask
What are some advantages of avoiding intubation? - ANS -better ability to communicate
-ability for the patient to take fluids and medications PO
What are the indications for NPPV? - ANS Acute exacerbation of COPD
-Acute hypoxemic respiratory failure
-acute cardiogenic pulmonary edema
-weaning from ventilatory support
-CAP
-post-op respiratory failure
-severe acute asthma
-DNR/DNI
What type of patient is NPPV used most in? - ANS Acute exacerbation of COPD
NPPV can temporarily reverse hypoxemia and hypercarbia associated with acute respiratory
failure. True or false. - ANS True
What is the criteria that determines a patient needs NPPV? - ANS VT = <3-5 L/kg
, Rapid Shallow Breathing Index (RSBI) = >130
Minute Volume = >10L/min
RR = >35/min
pH= <7.35
PaCO2 = >55mmHg
PaO2 = <50 mmHg on FiO2 >0.5
Assessment of a patient for NPPV should include - ANS -Determination of ventilatory
parameters (Vt, VE, f, and RSBI)
-ABG
-Oxygen Saturation
-WOB
-changes in pts VS
Tidal volumes of less than _________ mL/kg are indicative of impending ventilatory failure.
Why? - ANS 3 to 5 mL/kg
A patient cannot move sufficient volume greater than dead space volume....
Minute volume in excess of _____ L/min is indicative of impending failure. - ANS 10 L/min
The patient must use excessive muscle work to maintain this....it can't be maintained for long
periods
A respiratory rate greater than ____ per minute is indicative of impending failure. - ANS 35
breaths a minute
More muscle effort = cannot be sustained.
Rapid Shallow Breathing Index (RSBI) - ANS RR/VT
An index of 130 or more is an indication of impending failure. RSBI quantifies the relationship
between f and VT.
ABG analysis for indications of need for NPPV. What are the parameters? - ANS pH less
than 7.25
PaCO2 greather than 55mmHg (except in chronic hypercapnia)
PaO2 less than 50mmHg on a FiO2 greater than 0.5
It is important to trend against a patients NORMAL values.
A declining oxygen saturation or a saturation of less than ___% is indicative for NPPV. - ANS
90%.
Exam Questions And Answers
NPPV - ANS noninvasive positive pressure ventilation
bilevel positive airway pressure (BiPAP) - ANS noninvasive ventilation device like a CPAP
machine; however, it can be set at a higher pressure for inhaling and a lower pressure for
exhaling. IPAP AND EPAP!!!
continuous positive airway pressure (CPAP) - ANS a form of noninvasive positive pressure
ventilation (NPPV) consisting of a mask and a means of blowing oxygen or air into the mask to
prevent airway collapse or to help alleviate difficulty breathing
Definition of noninvasive positive-pressure ventilation - ANS The application of positive
pressure via the upper respiratory tract to augment alveolar ventilation.
What is NPPV used for? - ANS To provide improved alveolar ventilation to those patients in
acute respiratory failure, especially when intubation is not desirable
What interfaces are used with NPPV? - ANS -Nasal or full face mask
What are some advantages of avoiding intubation? - ANS -better ability to communicate
-ability for the patient to take fluids and medications PO
What are the indications for NPPV? - ANS Acute exacerbation of COPD
-Acute hypoxemic respiratory failure
-acute cardiogenic pulmonary edema
-weaning from ventilatory support
-CAP
-post-op respiratory failure
-severe acute asthma
-DNR/DNI
What type of patient is NPPV used most in? - ANS Acute exacerbation of COPD
NPPV can temporarily reverse hypoxemia and hypercarbia associated with acute respiratory
failure. True or false. - ANS True
What is the criteria that determines a patient needs NPPV? - ANS VT = <3-5 L/kg
, Rapid Shallow Breathing Index (RSBI) = >130
Minute Volume = >10L/min
RR = >35/min
pH= <7.35
PaCO2 = >55mmHg
PaO2 = <50 mmHg on FiO2 >0.5
Assessment of a patient for NPPV should include - ANS -Determination of ventilatory
parameters (Vt, VE, f, and RSBI)
-ABG
-Oxygen Saturation
-WOB
-changes in pts VS
Tidal volumes of less than _________ mL/kg are indicative of impending ventilatory failure.
Why? - ANS 3 to 5 mL/kg
A patient cannot move sufficient volume greater than dead space volume....
Minute volume in excess of _____ L/min is indicative of impending failure. - ANS 10 L/min
The patient must use excessive muscle work to maintain this....it can't be maintained for long
periods
A respiratory rate greater than ____ per minute is indicative of impending failure. - ANS 35
breaths a minute
More muscle effort = cannot be sustained.
Rapid Shallow Breathing Index (RSBI) - ANS RR/VT
An index of 130 or more is an indication of impending failure. RSBI quantifies the relationship
between f and VT.
ABG analysis for indications of need for NPPV. What are the parameters? - ANS pH less
than 7.25
PaCO2 greather than 55mmHg (except in chronic hypercapnia)
PaO2 less than 50mmHg on a FiO2 greater than 0.5
It is important to trend against a patients NORMAL values.
A declining oxygen saturation or a saturation of less than ___% is indicative for NPPV. - ANS
90%.
