The statement that is true concerning the use of permissive hypercapnia in the management of patients with acute respiratory distress syndrome (ARDS) includes which of the following?
a. The pH may be allowed to drop as low as 7.1.
b. Tromethamine (THAM) may be used to keep the pH above 7.2.
c. Partial pressure of carbon dioxide (PaCO2) needs to rise rapidly to achieve success.
d. PaCO2 should not be allowed to rise above 60 mm Hg.
ANS: B
Acceptable end points for the management of acute respiratory distress syndrome (ARDS) based on arterial blood gases (ABGs) are partial pressure of carbon dioxide (PaCO2) = 40-80 mm Hg; pH = 7.20-7.40; PaO2 = 60-100 mm Hg. Note that these values may vary among institutions. Some physicians prefer to use tromethamine (THAM) or sodium bicarbonate when pH drops be-low 7.20.
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