NURS 201 Lecture Notes - Barotrauma, Respiratory Alkalosis, Natriuretic Peptide
28 Apr 2013
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Document Summary
Ppv can affect circulation because of the transmission of increased mean airway pressure to the thoracic cavity. With increased intrathoracic pressure, thoracic vessels are compressed resulting in decreased venous return to the heart, decreased left ventricular end-diastolic volume (preload), decreased co, and hypotension. Mean airway pressure is further increased if titrating peep (>5 cm h2o) to improve oxygenation. Pneumomediastinum usually begins with rupture of alveoli into the lung interstitium; progressive air movement then occurs into the mediastinum and subcutaneous neck tissue. Volutrauma in ppv relates to the lung injury that occurs when large tidal volumes are used to ventilate noncompliant lungs (e. g. , ards): volutrauma results in alveolar fractures and movement of fluids and proteins into the alveolar spaces. Condensation that collects in the ventilator tubing should be drained away from the patient as it collects. Progressive fluid retention often occurs after 48 to 72 hours of ppv especially ppv with.
