Question

Mrs. J.’s condition does not improve. SpO2 is 85%, and the FiO2 is increased to 0.90 to maintain this. A decision is made to increase the PEEP to 20 cm H2O. About 10 minutes after the PEEP is increased, Mrs. J.’s blood pressure drops to 80/50 mm Hg. Breath sounds are equal bilaterally. What is the likely rationale for the drop in Mrs. J.’s blood pressure? What is the significance of the bilateral breath sounds?

Answer 1

ANSWER.

* Mrs.J's blood pressure decreased due to increase in PEEP to 20 cm H2O

because

               * Increased PEEP result rise in cental venous pressure.

               * It decreases the coronary blood flow to the heart.

               * It decreases venous return to heart,end diastolic volume and increases

                  afterload of the right ventricle.

               * All of the above changes which occur due to elevated PEEP value leads to

                 drop in blood pressure.

* Significance of bilateral breath sounds

              * Bilateral breath sounds are produced by lungs during breathing and it can

                 be heard through auscultation.

              * Normal breath sounds (bronchial,bronchiovesicular,vesicular) indicate normal

                 functioning of the respiratory system.

              * Abnormal breath sounds ( Crackles,rhonchi,strider,pleural rubs,wheezes etc)

                indicate abnormalities in the respiratory system( Inflammation,obstruction,infection

                presence of foreign body etc.)