- product of respiratory
Rate and
tidal volume; - note:
oxygenation is Independent of minute volume until ventilation is very low. hence: increasing minute volume does not improve oxygenation; - note: CO2 removal is directly dependent on minute volume. - pCO2 should be maintained at 40 mm or less; - w/
Met. acidosis: consider: - hypoperfusion, hypovolemia, or sepsis - w/
Resp. Acidosis: consider: - dislodge tube, leak, vent malf(x), Pneumo, Atelectasis - mild
Resp Alk is well tolerated. - w/ apnea pCO2 rises 3 mm/min, so that maintenance of mild resp alkalosis provides extra minutes during episodes of ventilator malfunction; - if CO2 is too high, Minute volume must be increased; - either increase
Tidal vol. or
Rate; - w/ High pCO2: must increase
Minute Vol; (always ensure that ventilator is functioning properly, esp check for a leak around the cuff of the endotracheal tube or in the ventilatory tube, or connections, or if the endotracheal tube has become dislodged - (Check Breath sounds / chest expansion) - if
tidal volume is already at the upper limits of suggested range, or if
peak inspiratory pressures are high ( > 50), or if there is prominent chest expansion w/ each breath, one would be inclined to increase
Rate rather than volume. - if the rate is already at the upper limits of range, or if
peak inspiratory pressures are low, and if chest expansion w/ each breath is not marked,
tidal volume may be safely increased. - w/ Low pCO2: must decrease
Minute Vol - note: mild
respiratory alkalosis is desirable, and usually minute ventilation is not decrease unless pCO2 < 30 mm Hg) - decr min. volume may occur by decr
Rate or
tidal volume. - however, a illogical method is by increasing the length of ventilator tubing;
