A patient is intubated due to hypercapnic respiratory failur…
A patient is intubated due to hypercapnic respiratory failure from an acute exacerbation of chronic obstructive pulmonary disease. The patient is now breathing on the vent with a set PEEP of 5 cm H2O. The patient is unable to flow trigger every inspiration. Unintended positive end-expiratory pressure (auto-PEEP) is measured at 10 cm H2O. After optimizing vent settings such as flow shape, Ti, f, and VT, the most appropriate action to take is which of the following?
Read DetailsA 36-year-old female patient with a history of asthma is adm…
A 36-year-old female patient with a history of asthma is admitted to the ICU from the emergency department and placed on nasal cannula 6 L/min. The patient is 5’5″ and weighs 135 lb. Respirations are 33 bpm, very labored, with accessory muscle use and bilateral inspiratory and expiratory wheezing. There is bilateral hyper resonance during chest percussion. after 1 hour of continuous aerosolized albuterol (15 mg) reveals: pH 7.32 (PaCO2) 45 mm Hg (PaO2) 53 mm Hg (SaO2) 88% (HCO3-) 25 mEq/L The most appropriate action at this time is which of the following?
Read DetailsA patient is receiving mechanical ventilation with a fractio…
A patient is receiving mechanical ventilation with a fractional inspired oxygen (FIO2) of 0.85 and a positive end-expiratory pressure (PEEP) of 5 cm H2O. His arterial partial pressure of oxygen (PaO2) is 68 mm Hg, arterial oxygen saturation (SaO2) is 88%, and partial pressure of end-tidal carbon dioxide (PetCO2) is 32 mm Hg. Over the next few minutes his PEEP is titrated resulting in the following data: Time FIO2 PEEP (cm H2O) SpO2 (%) PetCO2 (mm Hg) 0600 0.85 5 88 30 0630 0.85 8 88 30 0650 0.85 10 90 32 0720 0.80 12 93 34 0740 0.80 15 90 25 what action should the respiratory therapist take at this time?
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