A neonate of 30 weeks' gestation shows signs of respiratory distress after delivery,including grunting,nasal flaring,and cyanosis.The baby is placed on nasal CPAP at 6 cm H₂O with an F_IO₂ of 0.6.The grunting and nasal flaring are alleviated,and the ABG results on these settings are: pH = 7.20,PaCO₂= 64 mm Hg,PaO₂ = 48 mm Hg,SaO₂ = 70%,HCO₃^- = 21 mEq/L.The respiratory therapist should recommend which of the following?

Question

Quizplus · Accepted Answer

This neonate meets the requirements for invasive mechanical ventilation because of continued signs of respiratory distress: respiratory acidosis and a PaO₂ of 48 mm Hg with an F_IO₂ of 0.6.Remaining in CPAP would not address the respiratory acidosis or the hypoxemia.Increasing the CPAP level and the F_IO₂ would not address the respiratory acidosis.This patient is showing severe ventilatory impairment (pH < 7.25,PaCO₂ > 6 mm Hg)and refractory hypoxemia (PaO₂ < 50 mm Hg on an F_IO₂ > 0.6);therefore,the patient should not be placed on NIPPV.

A Neonate of 30 Weeks' Gestation Shows Signs of Respiratory