A patient diagnosed with ARDS is placed on PC-MCv at the following settings: PEEP 10cm H2O. FIO2 0.8. inspiratiry pressure 18cm H2O. PIP 28cm H2O. Vt 350mL. slope is set at the slowest flow rate possible. ABG reveals ph 7.28. PaCO2 49mm Hg, PaO2 53mm Hg. The previous PaCO2 of 40 mm Hg and PaO2 of 68mm Hg. The Rt notices that the PIP only reaches 23 cmH2O. no leak is found. What would you recommend to improve this patients ABGs and why?

Question

20-12-2024
Medicine

College

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A patient diagnosed with ARDS is placed on PC-MCv at the following settings: PEEP 10cm H2O. FIO2 0.8. inspiratiry pressure 18cm H2O. PIP 28cm H2O. Vt 350mL. slope is set at the slowest flow rate possible. ABG reveals ph 7.28. PaCO2 49mm Hg, PaO2 53mm Hg. The previous PaCO2 of 40 mm Hg and PaO2 of 68mm Hg. The Rt notices that the PIP only reaches 23 cmH2O. no leak is found. What would you recommend to improve this patients ABGs and why?

Answer :

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LorraineNoble LorraineNoble · Answer 1 · 2024-11-17T01:38:15-05:00

The therapist should adjust the inspiratory pressure (IP) to achieve higher peak inspiratory pressure (PIP).

When a patient is diagnosed with acute respiratory distress syndrome (ARDS), the patient's breathing pattern is irregular and fast, which leads to an insufficient amount of oxygen intake. This condition is life-threatening, so immediate and effective treatment is required. When a patient is placed on the pressure control mode (PC-MCv), it provides a constant pressure during inhalation.

In this case, the PEEP level is 10 cm H2O, the FIO2 is 0.8, the inspiratory pressure is 18 cm H2O, PIP is 28 cm H2O, and the Vt is 350mL. The slope is set at the slowest flow rate possible. The ABG results reveal pH of 7.28, PaCO2 of 49 mm Hg, and PaO2 of 53 mm Hg, which shows worsening from the previous results of PaCO2 of 40 mm Hg and PaO2 of 68mm Hg. The Rt noticed that PIP only reaches 23 cmH2O, and no leak is found. To improve this patient's ABGs, the therapist should adjust the IP to achieve higher PIP to provide better oxygenation.

Learn more about inspiratory pressure here:

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