When initiating noninvasive ventilation, what is your tidal volume in ml/Kg are you aiming to achieve?

Which of the following modes are utlizlied on noninvasive ventilators?   1.  CPAP   2.  BIPAP   3.  BIPAP S/T   4.  AVAPS

Patients with acute exacerbation of COPD should be evaluated for NIV as an alternative to intubation and mechanical ventilation.

All of the following would indicate need for terminating noninvasive ventilation for worsening patient status except:

A 29 year old patient who is morbidly obese is admitted to the ED with a productive cough, fever, and shortness of breath.  The patient’s vital signs are stable and he is awake and alert.  After initiation of bronchodilator therapy and antibiotics, results for serial blood gas analyses reveal:                                        07:00AM                                               08:00AM           FiO2                             0.21                                                       0.50              pH                             7.28                                                        7.22         PaCO2                            72 mmHG                                              85 mmHG           PaO2                           45 mmHg                                               56 mmHG          HCO3                            34 mEq/L                                                35 mEq/L               BE                            + 5 mEq/L                                              + 4 mEq/L At 8:30AM, the patient’s clinical condition remains unchanged and the physician asks for suggestions in therapy.  Which of the following should a respiratory therapist recommend?

You initiate BIPAP on a patient with the following settings: IPAP 10 EPAP 5.30 mins later you obtain the following ABG.pH        7.30PaCO2   50PaO2      50HCO3     24What changes would you make to the patient’s settings?

Which of the following are goals and benefits of noninvasive ventilation in the acute care setting?   1.  Reduces need for endotracheal intubation   2.  Relieves symptoms of respiratory distress   3.  Reduces length of time on ventilator   4.  Shortens stay in the intensive care unit and hospital stay

Fully interpret the following ABG. pH         7.23PaCO2   68PaO2      65HCO3     30

A patient has been utilizing BiPAP for several hours. Current settings are IPAP 16, EPAP 10.You obtain an ABG that states the followingpH        7.51PaCO2   27PaO2      88HCO3     24What would you recommend next?

NIV is initiated on spontaneous mode with FiO2 0.40, IPAP 8 cm H20, and EPAP of 2cm H20.  ABGs reveal pH 7.29, PaCO2 54, PaO2 52, and HCO3 30.  The respiratory therapist should recommend what change to address the carbon dioxide levels?