Page 751 - Clinical Application of Mechanical Ventilation

Glossary 717

transbronchial lung biopsy (TBLB): Tissue specimens collected by the forceps during a forced exhalation maneuver.
transbronchial needle aspiration biopsy (TBNAB): Tissue specimens collected by applying aspiration while moving the
needle at the sample collection site.
transcutaneous PCO 2 (P tc CO 2 ): Measurement of PCO through the skin by means of a miniature Severinghaus (PCO )
2
2
electrode.
transcutaneous PO 2 (P tc O 2 ): Measurement of PO through the skin by means of a miniature Clark (PO ) electrode.
2
2
transesophageal echocardiography: A method using a Doppler transducer in the esophagus for an indirect
measurement of the blood flow velocity in the descending aorta and the calculation of the cardiac output and other
hemodynamic data.
transport ventilator: A mechanical ventilator capable of operation without piped-in gas sources or electrical
connection.
transtentorial herniation: A type of brain injury that causes the downward displacement of the medial aspect of the
temporal lobe (uncus) through the tentorial notch by a mass above.
triage: A process that uses predetermined criteria to assign individuals from a large pool of people for grouping and
making decisions.
trocar: A sharply pointed instrument for incision into the chest cavity.

trocar tube thoracostomy: A technique of chest tube placement by incision into the pleura, insertion of trocar chest
tube, and withdrawal of trocar.
unplanned extubation: Unexpected removal of an endotracheal or tracheostomy tube before the patient is ready for
extubation.
V/Q mismatch: An abnormal distribution of ventilation and pulmonary blood flow. High V/Q is related to deadspace
ventilation, whereas low V/Q is associated with intrapulmonary shunting.
vagus nerve: The pneumogastric or tenth cranial nerve. Its superior and recurrent laryngeal nerves and their
branches adjoin the upper end of trachea and are sensitive to stimulation by the endotracheal tube or suction
catheter.
vallecula: An area between the base of the tongue and epiglottis; an anatomical landmark for the placement of the
curved (Macintosh) blade.
venous return: Blood flow from the systemic venous circulation to the right heart.
ventilation/perfusion (V/Q) mismatch: An abnormal distribution of ventilation and pulmonary blood flow. High V/Q
is related to deadspace ventilation, whereas low V/Q is associated with intrapulmonary shunting.
ventilator-associated pneumonia (VAP): A severe form of hospital-acquired infection of the lung parenchyma that
develops within 48 hours after intubation and initiation of mechanical ventilation.
ventilatory failure: Failure of the respiratory system to remove CO from the body resulting in an abnormally high
2
.
PaCO 2
vocal cords: Two thin, almost parallel folds of tissue within the larynx that vibrate as air passes between them; an
important landmark as the entry point to the trachea during intubation.

volume ventilation plus (VV+): An option that combines volume control plus and volume support.
volume-assured pressure support (VAPS): A mode of ventilation that assures a stable tidal volume by incorporating
inspiratory pressure support ventilation (PSV) with conventional volume-assisted cycles (VAV).
volume-controlled ventilation (VCV): Mode of ventilation in which a preset tidal volume is used to provide ventilation.
The airway pressures during this mode of ventilation are affected by the changing compliance and resistance.
weaning failure: Failure of spontaneous breathing trial (SBT) or the need for reintubation within 48 hours following
extubation.

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