A mechanically ventilated patient is going to be placed on p…
A mechanically ventilated patient is going to be placed on pressure support ventilation following an acceptable spontaneous weaning trial. The patient is a 5’9” male who weighs 185 lbs. During volume-controlled continuous mandatory ventilation (VC-CMV) his average peak inspiratory pressure (PIP) averaged 26 cm H2O and the plateau pressure (Pplateau) was 16 cm H2O with 5 cm PEEP. What initial pressure support level should be set to overcome the patient’s resistive work of breathing?
Read DetailsA 68-year-old female admitted for congestive heart failure i…
A 68-year-old female admitted for congestive heart failure is in respiratory distress and is being seen by the hospital’s medical emergency team in her regular room. The patient is in obvious respiratory distress and is immediately placed on a non-rebreathing mask. Physical assessment reveals: pulse 138 and thready; respiratory rate 30, shallow and labored; temperature 37° C; blood pressure 110/68. Breath sounds are bilaterally decreased with coarse crackles on inspiration. EKG shows normal sinus rhythm and an occasional irregular beat. No coughing is noted. The arterial blood gas on the non-rebreathing mask is: pH 7.34; PCO2 46 mm Hg; partial pressure of oxygen (PaO2) is 52 mm Hg; oxygen saturation is 86%; bicarbonate (HCO3-) is 24 mEq/L. The patient is diaphoretic. The most appropriate ventilator mode to manage this patient initially is which of the following?
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