A patient with ALI is being ventilated using APRV with the following settings: Phigh = 30 cm H2O; Plow = 2 cm H2O; Thigh = 6 seconds; Tlow = 0.8 sec; FIO2 = 0.4. The patient's spontaneous rate is 12 breaths/min
The current ABG values are: PaO2 = 61 mm Hg; PaCO2 = 43 mm Hg. What change should the respiratory therapist recommend for this patient?
a. Decrease the Phigh to 25 mm Hg.
b. Increase the Thigh to 8 seconds.
c. Decrease the Tlow to 0.5 second.
d. Increase the Plow to 5 cm H2O.
ANS: B
To improve oxygenation during the use of APRV, the Phigh establishes the mPaw, which maintains oxygenation by restoring the functional residual capacity. Decreasing the Phigh would derecruit some alveoli and may create a more difficult situation. Increasing the Thigh may be done in 0.5- to 2-second intervals until the oxygenation target is achieved. The Tlow aids the removal of CO2 and helps determine tidal volume.
You might also like to view...
Only adults over 65 are eligible for Medicare
Indicate whether the statement is true or false
The time from when a drug is administered until it reaches the minimum effective concentration is known as the:
A) peak action. B) therapeutic interval. C) onset of action. D) duration of action.
When the time spent in a higher radiation area is reduced or limited, occupational exposure
a. is also reduced. b. is increased slightly. c. remains the same. d. is increased considerably.
Standard treatment for a muscle strain includes rest, ice, compression and:
a. elevation b. elongation c. exercise d. extension