According to the U.S. Food and Drug Administration, which of the following mechanical ventilatory rates constitutes high-frequency ventilation (HFV)?
D. More than 150 breaths/minute
Enhanced diffusion is a function of which of the following factors?
I. Inspiratory flow
II. Plateau pressure
III. Tidal volume
IV. Respiratory frequency
B. III and IV only
What is the relationship between the tidal volume and the dead space volume in the context of high frequency ventilation?
C. Dead space volume is greater than the tidal volume
Which of the following, forms of mechanical ventilation is the most efficacious method for acquired bronchopleural fistulas?
A. High-frequency jet ventilation (HFJV)
Which of the following statements best describes the relationship between tidal volume and frequency during HFJV of pediatric and neonatal patients?
B. Neonatal patients need higher frequencies and lower tidal volumes than pediatric patients.
During HFOV, which of the following factors has a direct influence on a neonate’s delivered tidal volume?
I. Frequency
II. Oscillatory amplitude
III. Peak inspiratory pressure
IV. IPAP (inspiratory positive airway pressure) and EPAP (expiratory positive airway pressure)
A. II only
During HFOV, manipulation of which of the following components establishes the continuous distending pressure?
I. Gas flow through the pneumotachometer during expiration
II. Peak inspiratory pressure-trough pressure gradient
III. Expiratory valve aperture
IV. Bias flow
B. III and IV only
What is the recommended inspiratory time percent setting for HFOV?
A. 33%
Which of the following factors need to be considered for HFV ventilator circuits?
I. Time for gas egress during exhalation
II. Circuit compliance
III. Endotracheal tube size
IV. Intrinsic timing mechanisms
B. I, II, and IV only
What is the primary therapeutic goal when a patient with lungs prone to atelectasis receives HFV?
B. To optimize lung inflation
How is the high-volume strategy achieved when the goal is to deliver a high lung volume to a neonate receiving HFV?
A. By increasing the continuous distending pressure
What is a frequent requirement when employing the low-volume strategy while ventilating a neonatal patient with pulmonary interstitial emphysema by HFV?
B. High inspired fraction of oxygen (FlO2)
How is the minute ventilation decreased when a patient is being weaned from HFOV?
A. By reducing oscillatory amplitude
How is the radiographic assessment of neonatal lung volume assessed?
B. Counting the number of posterior ribs above the diaphragm
What are the consequences of failing to quickly wean a neonatal patient from HFV?
I. Pulmonary over distention
II. Pulmonary hypertension
Ill. Alveolar derecruitment
IV. Impaired cardiac output
B. I and IV only
Why did the original version of the Bunnell Life Pulse HFJV require a triple-lumen, high—low ETT?
I. For injection of jet breaths into the proximal EU lumen
II. For sampling pressure at the distal EU lumen
III. For suctioning through the mid-portion of the EU lumen
IV. For connection to conventional ventilation through the proximal EU lumen
C. II and IV only
Which of the following features characterize neonatal HFOV circuits?
I. Larger diameter tubing for inspiratory gas flow
II. Narrower diameter tubing for exhalation
Ill. High-compliance tubing
IV. Tubing with internally corrugated walls
B. I and II only
Which of the following steps might be involved when a therapist assesses a patient suspected of having a reduction of airway diameter while receiving HFV?
I. Observe the patient’s chest wall for movement.
II. Increase conventional ventilation.
III. Apply ventilation via a manual resuscitation bag.
IV. Reduce the oscillatory amplitude.
B. I and IV only
Why may HFOV not be an optimal ventilation strategy for patients who have either fresh particulate meconium aspiration or bronchopulmonary dysplasia?
A. Gas trapping may develop.
Which of the following issues continue to confront the practice of surfactant replacement therapy?
I. Type of HFV device to use
II. Nature of surfactant to administer
III. Timing of surfactant replacement
IV. Method of delivery during HFV
