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Old 06-11-2011
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Arrow question from kaplan small group workshop

A pt is suffering from smoke inhalation injury is mechanically ventilated.his condition is stable but he is completely paralysed and relies on accurate ventilator settings to maintain his blood gas status.
his respiratory parameters are;

tidal volume 500 ml
R/R 15/min
FiO2 40%
PEEP 8 cm H2o
I:E 1.02

an arterial sample is drawn and produces following result

pH 7.54
pCO2 35 mmhg
pO2 90 mmhg
HCO3 25 mEq/l

ASSUMING HE HAS A SIMPLE DISTURBANCE which of following alterations in respiratory parameter will correct his disturbance..

a)dec FiO2
b)dec PEEP
c)dec R/R
d)inc Fio2
e)inc tidal voulume

APART FROM THIS QUESTION CONSIDERING SAME STEM IS IT A RESPIRATORY/METABOLIC or MIXED ALKALOSIS?

as far as i know first i see ph its inc so its alkalosis.then both HCO3 and PcO2 moved in OPPOSITE direction . so it should be mixed..what u guys think..
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usluipek (06-11-2011)



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Old 06-11-2011
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i think u shud decrease the PEEP and yeah seems like mixed picture because the pco2 is borderline decreasd and HCO3 is increased..if it were simple metabolic alkalosis then the pco2 wud have been increased to compensate.
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Old 06-11-2011
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respiratory alkalosis

decrease R/R

PS, IKR 123, thanks for sharing and hope you have another productive day tomorrow.......
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  #4  
Old 06-11-2011
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What is the correct answer, IRK 123? Thanks!
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