Chapter 2

Created by jimmgym 

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External Respiration

O2 from LUNGS to BLOOD and CO2 from BLOOD to LUNGS

Internal Respiration

Cellular Level..O2 from BLOOD to CELLS and CO2 from CELLS to BLOOD

Gas flow from

high pressure to low pressure

Units of Pressure

mmHg, cmH2O(vents) kPa (kiipascal)

Mouth Pressure

Airway Pressure (Paw)

Alveolar Pressure

Palv

Alveolar pressure AKA

iNTRAPULMONARY PRESSURE

Pressure at BODY SURFACE

Pbs

Intrapleural Pressure

Ppl

Transairway Pressure

Pta..pressure gradient between mouth and alveoli..Produce air movement

Transairway Pressure Formula

Pta=Paw-Palv

Transthoracic Pressure

Pressure gradient between alveoli and body surface...expands the lung and chest wall

Transthoracic Pressure Formula

Ptt=Palv-Pbs

Transpulmonary Pressure

Pressure gradient between alveoli and pleural space..maintains alveolar inflation.

Transpulmonary Pressure Formula

Ptp=Palv-Ppl

Compliance

Ease with which the lungs distent...opposite of elastance...Think, big red balloon.

Compliance abbreviation

C or Cl

Compliance formula

Cl=change in V/change in P Cl=ml(volume) / cmH20 (pressure)

Normal Cl in spontaneous breathing pt.

100 ml/1cmH20

Normal Cl in Ventilator pt

35-50 ml/1cmH20

Increase in Compliance....good or bad?

Good...Less pressure required to inflate lung.

decrease Compliance...good or bad?

Bad..More pressure required to inflate lung.

Resistance

Frictional resistance to gas flow...(the size of the airway)

Airway resistance

Raw

Things that decrease diameter of airway

bronchospasm..inflammation(edema)..increase in secretions,,ET tube

Increase in resistance...good or bad?

Bad...more pressure required to inflate lung (small straw)

decrease in resistance...good or bad?

Good...Less pressure rrequired to inflate lung (big straw)

Normal resistance for spont. breathing pt

0.6-2.4 cmH2o/l/sec

normal resistance for vent breathing pt

5-6 cmH2o/l/sec

Times Constants

How many seconds are needed to fill

I:E Ratio

How many part Inspiratory to expiratory (Total Cycle Time)

Negative Pressure Ventilators(Iron Lung)

INHALE mouth pressure > Alveolar pressure...Gas flows into lungs EXHALE Negative pressure removed, passive exhalation

Positive Pressure Ventilators

ET Tube, CPAP, Mouth Piece, Trach

High Freq. Ventilation

Ventilator that provides High Resp. Rate, Low Volumes..PISTON pushes gas in on I...draws gas out on E

HFJV

High Frequency Jet Ventilator...Rates 100-600 bpm

HFOV

High Frequency Ocillatory Ventilator...Rates up to 4000 bpm

Indications for High Freq. Vent

ARDS..and infants with surfactant issues

Baseline Pressure

Where Inspiratory starts and Expiratory ends

Peak Pressure (PIP)

The highest pressure of the breath, I

Increase in PIP

Increase in Resistance, Decrease in compliance

Decrease in PIP

Decrease in resistance, Increase in compliance

Plateau Pressure (Pplateau)

Set for one sec. Breath hold at the end of Inspiration...measures pressure with NO gas flow .TRUE PICTURE OF LUNG COMPLIANCE(STIFFNESS)

Settings for Pplateau on VENT

Inspiratory Pause, Inspiratory Hold, Plateau

disease that leads to INCREASED compliance

emphysema

4 factors that change the ability of air to flow through the conducting airways

1 gas viscosity, 2 gas density 3 diameter of the tube 4 flow rate of the gas

increased resistance of 13-18

indicates disease such as emphysema and asthma and other obstructive disorders

higher resistance

less pressure in alveoli, smaller volume of gas available for gas exchange. Accessory muscle use, for breathing.

A stiff lung..

fills and empties quickly, but gets less volume

A lung with increased resistance..

fills slowly, if normal amount of time is allowed, the lung will receive less volume

Static Compliance

Recorded when there is no movement of air

Static Compliance Formula

Cs=Vt / Pplateau-Peep

Dynamic Compliance

Recorded with movement of air

Dynamic Compliance Formula

Cd=Vt / PIP-Peep

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