A 28-year-old female (55-kg IBW) is being mechanically ventilated with VC-CMV, f = 14/min, VT = 700 mL. The patient has no history of pulmonary disease. The resulting ABG values are: pH 7.55, PaCO2 27 mm Hg, HCO3? 23 mEq/L
The most appropriate action to take is which of the following?
a. Decrease VT to 600 mL.
b. Decrease VT to 450 mL.
c. Decrease f to 12/min.
d. Decrease f to 10/min.
ANS: B
The original volume setting exceeded the maximum VT for this patient. The VT should be set between 275 and 440 mL to achieve 5-8 mL/kg IBW. Therefore, the VT must be reduced to avoid overdistention. Using the formula:
Desired VT ??Known PaCO2 ⋅?Known VT / Desired PaCO2
Desired VT = 473 mL
The VT of 450 mL is closest to the desired VT and is more in line with the acceptable range.
You might also like to view...
In a PPO program, the primary care physician acts as a
A. case manager. B. specialist. C. primary care physician. D. gatekeeper.
The term "walking wounded" is sometimes used to describe patients in the START Minor category.
Answer the following statement true (T) or false (F)