An 18-year-old,5'6" and 125 lb female patient was admitted to the hospital 2 days ago for spinal meningitis.She developed sepsis and suffered hypercapnic respiratory failure.The patient was intubated and placed on volume-controlled continuous mandatory ventilation (VC-CMV),respiratory frequency (f)12 bpm,tidal volume (V_T)600 mL,positive-end-expiratory pressure (PEEP)5 cm H₂O,fractional inspired oxygen (F_IO₂)40%.Twenty-four hours later,the patient's oxygen requirements have dramatically increased and her lung compliance has dramatically dropped,while her chest x-ray showed development of bilateral fluffy infiltrates.The most appropriate actions to take include which of the following?

Question

Quizplus · Accepted Answer

During the acute phase of the disease,adequate ventilation should be provided using a tidal volume (V_T)in the range of 4 to 6 mL/kg while plateau pressure (P_plateau)is maintained at < 30 cm H₂O with rates of 15 to 25 breaths/min.For this patient the V_T range should be between 244 and 488 mL with a rate between 15 and 25 bpm.Answer "B" fits into this guideline.

An 18-Year-Old,5'6" and 125 Lb Female Patient Was Admitted to the Hospital