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PEEP & CPAP (Exam 1) Questions And 100% Correct Answers
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PEEP & CPAP (Exam 1) Questions And 100% Correct AnswersPEEP - Answer recruits some collapsed alveoli
increases FRC & increases compliance in the dependent are (lower lobe) of lung
*compliance is decreased in the non-dependent (upper lobe) area of the lung due to
overdistention
Indications of PEEP - Answer Refractory Hypoxemia (will not respond to supplemental
O2)
Shunt of >30%
Atelectasis with decreased FRC
decreased compliance
Certain disease processes
Goals of PEEP - Answer improve tissue oxygenation
keep PaO2 >60 & SpO2 at or >90% @ acceptable pH
Recruit alveoli & maintain
Restore FRC
Establishing PEEP - Answer FIO2 >.50
PIP >35 cwp
is PaO2 still <60: then begin to increase PEEP by 3-5 until:
1. acceptable oxygenation achieved
2. unacceptable side effects occur:
decreased compliance
decreased cardiac function
barotrauma
, Levels of PEEP - Answer Minimum "physiologic" 3-5
moderate 5-15
maximum >15
Optimal - PEEP level which achieves maximum benefits with least side effects
Physiologic Effects of PEEP on: - Answer PaO2 - up
FRC - up
PaCO2 - down
BP - down
PvO2 - improves
Intrapulmonary shunt - down
Cardiac output - down
Ca-v O2 - down
ICP - up
Compliance - improves
ARDS causes: - Answer decrease compliance
decrease FRC
increase PVR
decrease v/q mm
increase shunt
PEEp will help improve all of the above by reaching the critical opening pressure
thereby reducing the shunt
Other uses/indications for PEEP/CPAP -Answer *CHF - cardiogenic pulmonary edema (L
heart failure, clinical presentations: pink, frothy secretions)
Benefits: decreases venous return/amt of blood to pump, increases FIO2
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