A patient being actively weaned from mechanical ventilation currently is receiving the following ventilatory support: pressure support = 15 cm H2O,
spontaneous VT = 575 mL, spontaneous rate = 14 breaths/min, spontaneous VT = 500 mL, FIO2 = 35%, PEEP = 5 cm H2O. The arterial blood gas results are: pH = 7.42, PaCO2 = 38 mm Hg, PaO2 = 94 mm Hg, SaO2 = 98%, HCO3– = 24 mEq/L. What should the respiratory therapist do next?
a. Reduce PEEP to zero.
b. Reduce the FIO2 to 30%.
c. Reduce the PS to 10 cm H2O.
d. Extubate the patient.
ANS: C
At this point, the ABG results show no acid-base imbalance and no hypoxemia. The parameter that should be reduced is the pressure support. When pressure support is reduced to about 5 cm H2O, the pressure level is not high enough to contribute significantly to ventilatory support. Once at PS 5 cm H2O, the patient will be ready for a cuff leak test.
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