Question

A 28-week gestational age infant is receiving ventilatory support by a high frequency oscillation ventilator (HFOV) after being administered surfactant to treat severe IRDS. Heart rate is 150/min and blood pressure is within normal limits. Arterial blood gas results on high frequency ventilation are as follows:

pH 7.25 PaCO2 65 torr PaO2 62 torr HCO3- 27 mEq/L BE + 1 mEq/L The respiratory therapist should recommend
A. increasing FIO2
B. decreasing expiratory pressure
C. decreasing driving pressure
D. increasing oscillatory amplitude

Answer 1

The respiratory therapist should recommend increasing oscillatory amplitude on the HFOV to improve the baby's ventilation and oxygenation, as indicated by the blood gas results showing respiratory acidosis.

Step-by-step explanation:

A 28-week gestational age infant is receiving ventilatory support by a high frequency oscillation ventilator (HFOV) after being administered surfactant to treat severe Infant Respiratory Distress Syndrome (IRDS).

Based on the arterial blood gas results provided, with a pH of 7.25, PaCO2 of 65 torr, PaO2 of 62 torr, bicarbonate (HCO3-) level of 27 mEq/L, and a base excess (BE) of +1 mEq/L, the infant is experiencing respiratory acidosis with inadequate oxygenation.

To improve oxygenation and lower the PaCO2, the respiratory therapist should recommend increasing oscillatory amplitude. This adjustment will increase the volume of gas exchanged with each oscillation, helping to improve ventilation and thus reduce PaCO2 and increase PaO2.