Auteur: Giorgio A. Iotti
Date: 03.04.2023
The patient is a 174-cm male with an IBW of 70 kg. What do the respiratory mechanics tell us about this patient? Are the values selected here by ASV appropriate? If not, what would you do?
The patient has very low compliance with normal resistance. The expiratory time constant is therefore very short. Together with the need for high Oxygen, this is a strong indication of severe ARDS.
The values selected by ASV are appropriate: The Vt as low as 4.4 ml/kg (combined with a frequency higher than 20/min) is associated with a driving pressure and plateau pressure of 14 and 23 cmH20 respectively, both within safe limits.
Arterial pH and PaCO2 should be checked: It is highly likely that excessive respiratory acidosis is present and needing to be compensated by increasing %MinVol.
PEEP needs to be increased. A recruitment maneuver and/or prone positioning should be considered.