2/25/2017 MechanicalVentilationFormulasandNormsFlashcards|Quizlet

Mechanical Ventilation Formulas 69 terms rrtstudyme

and Norms
a/A ratio PaO2/PAO2 norm is 90%,
>35%weaning, reflects efficiency of
oxygenation as a percentage,
<74%shunt, V/Q mismatch or diffusion
defect

A-aDo2 A-a gradient, norm 5-10 mmHg on .21,

30-60 on 100%, >350mech support,
<350 weaning. Represents potential to
Oxygenate vs. the amount of O2 in the
artery. Every 50mmHg is approx. 2
percent shunt above norm of 2-5%

Alveolar Air Equation (pb-47)FIO2-(PaCO2x1.25), norm 80-

100mmHg (can reach 675 on 100%),
press of O2 in the Alveoli at any given
Pb, represents potential for arterial
oxygen

BP norm 120/80 (90-140/60-90), <90/60

or >180/110 is inconsistent with
weaning

CaO2 norm 20 vol% (Hbx1.34)SaO2 +

(PaO2x.003) total amount of O2
carried in 100ml of blood, combined
content of O2 carried on Hb and

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dissolved in plasma, (can be reduced

by <Hb, anemia or <CO)

CcO2 Content of pulm capillary blood

oxygen at 100% FIO2, (Hbx1.34)1 +
(PAO2x.003) used in shunt equation

CD dynamic compliance, aka CLdyn, norm

is .003-.004L/cmH2O (30-
40mL/cmH20), calc is Vt(L)/(PIP-PEEP)
Changes in CD indicate changes in CL
or elastance. Up with decreased
elasticity (emphysema, down with with
stiff (ARDS).

CI cardiac index, 2.5-4 L/min, <2.1

inconsistent with weaning

Cs (CVAE) static compliance, norm for vent pt is

.035-.055L/cmH20 or 35-
55mL/cmH20, calc is Vt/(Pplat-PEEP),
represents the combination of lung
elasticity and chest wall recoil while
on vent. Down with stiff lungs,
>35ml/cnH2O weaning

Ct Tube compliance aka compressible

volume, volume lost to pt circuit,
approx 3ml/cmH20 x PIP, deduct from
VT to find actual delivered tidal
volume. VT-(PIP x 3) equals actual VT.

CvO2 (Hb x 1.34)SvO2 + (PvO2 x .003) norm

is 15 vol%, represents the value of O2
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in blood returning to the right side of

the heart after tissues have
oxygenated.

CVP central venous pressure, norm 2-6

mmHg, 2-6 weaning

Deadspace ventilation in excess of perfusion

(pulm emboli)

DO2 O2 Delivery, (CaO2 x CO) x 10, norm is

1000mL/O2/min

FIO2 for weaning <40-50% weaning

Flow (VT/IT) x 60 or VE x (I+E)

Flow required for a 1 .750 equals L/sec x 1 or .750L/sec flow.

second I-time and a VT To convert to L/min .750 x 60 equals
of 750cc? 45L/m, this is the vent flow setting to
deliver a VT in 1 second I-time.

Hb 12-16 g/100ml of blood, (no anemia or

>10g for weaning)

HCO3 22-26 torr

HCT 40-50%

High press on vent obstruction (90% of time is secretions)

HR norm 60-80, 60-120 weaning

I:E ratios/% 1:233%, 1:325%, 1:420%

IBW F 105+5/lb over 60"

IBW M 106+6/lb over 60"

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I-time represents relationship for volume

(Liters), flow (L/sec) and time
(seconds). V eq F x T or F eq V/T

Low press on vent leak in system

Magic Box TIIVR+TIVER, FRCTIIVRTLC, IRV, IC,

VC, RV, + TIVER, FRCTLC, IRV, VT, ERV,
RV, FRC

MAP Mean arterial pressure, norm 90 (80-

100), 70-130 weaning

MIP/NIF Max Inspiratory Press, norm -80 - -100,

> -20 support indicated, <-20 weaning
(remember that negative numbers are
larger as they become less, -25 < -20)

PaCO2 35-45 torr, >55 indicates support, <50

weaning

PaCO2 to increase with <PIP, <RR, >PEEP

pt on mech vent

PaCO2(d) CO2 desired, CO2 is adjusted by

changing Resp rate so
(VExCO2)/CO2dVEd or (RRset x
CO2)/CO2dRRd, always round down
and go slightly acidic as tissue will
oxygenate better.

PaCO2-to decrease with >PIP, >RR, <PEEP

pt on mech vent

PaO2 80-100 torr, >60 mmHg on <60%

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weaning

PaO2 <80 on FIO2 <60 V/Q mismatch

PaO2 <80 on FIO2 >60 shunt, refractory hypoxemia or venous

admixture

PaO2 desired PaO2 (desired) x FIO2 (current)/PaO2

(current)FIO2 required to bring PaO2
to desired level. Example of pt on
40% FIO2, PaO2 of 53 and wanting
PaO2 of 80, calc is (80x.4)/53 equals
.60, so increase FIO2 to 60%

PaO2/FIO2 PaO2/FIO2, norm 350-450mmHg,

<300 indicates acute lung injury, <200
indicates ARDS, >200weaning,
measures o2 efficiency

PaO2-to decrease while <PIP, <RR, <PEEP, or <FIO2

pt on mech vent

PaO2-to increase while >PIP, >RR, >PEEP, or >FIO2

pt on mech vent

PAP pulmonary artery pressure, norm

25/10 (20-35/5-15), >35/15 is
inconsistent with weaning, pulm
hypertension, left vent fail, fluid
overload

PCWP pulmonary artery wedge pressure,

norm 5-10 mmHg, >18 is inconsistent
with weaning, left vent failure, fluid
overload
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PEEP positive end expiratory pressure

above baseline of 0, norm 3-5 (5-
8/ARDS)

PH Norm 7.35-7.45, <7.20 indicates

support, >7.35 weaning

PIP Peak pressure, norm is <50cmH2O, the

press required to overcome both
compliance and resistance

PvO2 40 torr

QS/QT Pulmonary Shunt equation (CcO2-

CaO2)/(CcO2-CvO2) Norm 2-3%,
>20% vent indication, <20% weaning,
>30% is life threatening. Measures % of
QT not exposed to ventilation, shunts
caused by atelectasis, edema,
pneumonia, pneumothorax,
obstructions

QT cardiac output, norm 5L/min (4-8)

RAW (RIAF) Airway Resistance norm is 5-

12cmH2O/L/Sec for intubated pt, (PIP-
Pplat)/(flow in min/60 sec). Increase in
RAW reflects an issue with airways,
bronchospasm, secretions, edema etc.

Refractory hypoxemia hypoxemia that does not respond to

O2 therapy

RR respiratory rate, norm 12-20, >35

indicates support, 6-30 weaning
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RSBI Rapid shallow breathing index, RR/VT,

<105 weaning, must be calculated
during spont breathing, press support
reduces predictive value

RV Residual Volume 1.2 L

SaO2 97-100%

Shunt perfusion in excess of ventilation

SvO2 75vol%

TC Time constant, (Raw x CS)e, where e

represents volume exhaled as a
percent, 1 is 63%, 2 is 86%, 3 is 95%
and 5 is 100% exhaled. TC <3 leads to
air trapping.

TCT total cycle time, 60 sec/RRset, amount

of time for a single breath cycle both I
and E. If I:E is 1:2 then TCT is 3

TLC total lung capacity 6L

VA Alveolar ventilation, (VT-VD) x RR,

represents sum of breaths taking
place in gas exchange, norm 4-5
L/min

VC Vital capacity, 65-75 mL/kg, <10mL/kg

indicates support, 10-15
mL/kgweaning

VD Deadspace volume, VD(VT-VA), norm

is 33% of VE, 1 mL/lb IBW or 2.2mL/kg
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(approx 150 ml)

VD/VT Ratio Deadspace to VT ratio, norm 24-40%,

>60 indicates support, <60% wean,
increase (w/no change in VE) indicates
decreased blood flow to alveoli,
usually caused by emboli, excessive
PEEP, or emphysema

VE Minute ventilation, VEVT x RRset, flow

of expired gas in one minute, norm 5-
8L/min, < 10 weaning

VEspont VEtot-(VTset x RRset), norm 5-6 L/min,

VO2 O2 consumption, norm is

250mL/O2/L/min, [C(a-v)O2 x QT] x
10, the amount of O2 consumed by the
body per liter of blood per minute.

VTspont VEtot-(VTset x RRset)/(RRtot-RRset)

Measured when machine in SIMV
mode, represents what the patient is
actually breathing on his/her own.

VT norm is 5-8 mL/kg (400-600 cc),

<5mL/kg indicates support, >5
weaning.

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