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Ventilator Quick Summary

Ventilator Modes
A/C - assist control - rate, volume, PEEP and FiO2 are specified
--- If rate is set at, say, 12/min and volume at 400cc then the pt will inhale 400c 12 x / minute whether they like ot or not.
--- PEEP - the pressure remaining after exhaltion
--- FiO2 - the fraction of inspired O2
--- To adjust pH change - volume*rate = minute ventilation - which will determines CO2
--- To adjust O2 - controlled by PEEP & FiO2
--- Intubation sided effect - external pressure (vs internal vacuum) causes decreased venous return which decreases BP.
--- Given the foregoing, what causes post-intubation diuresis ?  When the BP increases, GFR increase and patients diurese.
--- Size of breathing tube - look for the mark at the lip line. Usually 7, 71/2 or 8. 6 is pediatric.

Weaning:
CPAP - Every AM a trial of extubation is performed via pressure support ventilation (CPAP = Continuous Positive Airway Pressure)
--- Now the pt determines their rate and volume. The machine assists their effort by providing PEEP and FiO2
--- Bad outcome = increased BP > 20, RR increases from the 16 range to 30 range, or tidal volume starts to drop.
--- After 1/2 hour ABGs are checked and if good the patient is weaned.

Bridging to CPAP if necessary.
BIBAP - bilevel postive airway pressure
--- it is non-invasive, positive pressure ventilation
--- everything the patient exhales, the mask gently pushes pressurized air into the mouth and re-inflates the lungs, starting a new breath.

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