An 84-year-old male with severe chronic obstructive pulmonar…
An 84-year-old male with severe chronic obstructive pulmonary disease (FEV1 20% predicted, on 4 L/min home O2) is admitted with severe hypoxemic respiratory failure due to a Streptococcus pneumoniae infection. He is intubated and placed on volume control-assist control ventilation with a set TV of 400 mL (6.5 mL/kg IBW), PEEP of 8 cm H2O and a respiratory rate of 30 breaths per minute. When the paralytic used for intubation wears off, the patient is noted to be triggering additional spontaneous breaths with a total respiratory rate of 36 breaths per minute, and his exhaled TVs vary from 100 to 800 mL. During an end-expiratory pause, his airway pressure is 18 cm H2O. Which of the following is the MOST accurate statement regarding his ventilator settings?
Read DetailsA 67-year-old female with a medical history of COPD has been…
A 67-year-old female with a medical history of COPD has been experienced increasing dyspnea, which is now more prominent at rest. She has a slight increase in sputum production for the last 3 days at home. Sputum remains clear to white. She is short of breath, but able to speak in full sentences. The patient’s last hospitalization for COPD was 3 years ago. WBC is 8,800/mm3, sodium 142 mmol/L, BUN 16 mg/dL, creatinine 0.9 mg/dL. Nasal swab for MRSA is negative. Based on these findings, what is the best treatment?
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