Question

A 45-year-old, 6foot-tall man presented to the emergency department with a 2-day of fever and productive cough with copious amounts of brown sD hemodynamically stable with a blood pre nt with a 2-day history sputum. He was ssure of 130/87 mm Hg. His chest radio ed a right middle lobe infiltrate, and his room air arterial blood gas (ABG) is as show follows pH 7.32; PaCO2 32 m rnHig (НСО,-) 18 mEq/L; (mLg/L), and Pao2 78 nm Hg. He started on antibiotics and a because she is concerned that he is doing worse. On your arrival at hi 85/60mm Hg, his pulse is 120 beats, min and his oxygen saturation, which had been 97% on 2L of oxygen via nasal cannula, is now 78% on a nonrebreather mask. dmitted to the floor. Four hours later, the nurse calls vo s room, his BP is The patient is dis playing labored breathing with accessory muscle use and is less responsive than he was n admission. He is diaphoretic and is not able to talk. Lung examination reveals that he has crackles bilaterally in the bases posteriorly. You obta increasing bilateral, diffuse lung opacities. An ABG is done while he is on the nonrebreather mask, and it shows: pH 7.17; PaC02 45 mm Hg; HCO3- 14mEq/L; and Pa 58 mm Hg. in a chest radiograph, which shows

Answer 1

Answer 1: As flow increased, inspiratory time decreases which effect flow and generally applies to volume controlled flow limited ventilation. An increase in inspiratory flow or a decrease in tidal volume delivered by the ventilator is associated with prompt increases in respiratory frequency.

There will be pressure control and better synchrony due to varying inspiratory flows which protect lungs by limiting pressure. To ensure the patient recieves the appropriate Minute Ventilation (VE) required to satisfy respiratory needs with ventilation and oxygenation. The inspiratory time is indirectly proportional to the tidal volume. Hence an increase in the inspiratory time will decrease the airway pressure.