A female patient (59-kg IBW) with no history of pulmonary disease is being invasively ventilated with VC-CMV, f = 12/min, VT = 470 mL, PEEP = 5 cm H2O, FIO2 = 0.5
ABG results with these settings are: pH 7.31, PaCO2 54 mm Hg, PaO2 92 mm Hg, SaO2 90%, HCO3? 24 mEq/L. The most appropriate action for the respiratory therapist to take is which of the following?
a. Increase f to 16/min.
b. Increase VT to 635 mL.
c. Decrease VT to 400 mL.
d. Decrease PEEP to 3 cm H2O.
ANS: A
The target VT for an individual without pulmonary disease is 5-8 mL/kg IBW. This patient's VT range is 295-472 mL, meaning that the upper limit of this range has been reached. The f should be changed to increase this patient's minute ventilation.
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