Question

A spontaneous breathing trial was initiated on an intubated, awake, and alert 70 kg (154 lb) patient. After 30 minutes on an FIO₂ of 0.30, ABG results are as follows: pH 7.39, PaCO₂ 44 torr, PaO₂ 85 torr, and HCO⁻₃ 24 mEq/L. The patient's vital signs have remained stable throughout the trial. Which of the following is the most appropriate recommendation?

A. Maintain current therapy.
B. Initiate NPPV.
C. Add 5 cm H₂O CPAP.
D. Extubate the patient.

Answer 1

Based on the stable vital signs and ABG results, the most appropriate recommendation would be to extubate the patient.

Step-by-step explanation:

Based on the ABG results, the patient's blood pH is within the normal range (7.35-7.45), indicating that the acid-base balance is normal. The PaCO₂ level is 44 torr, which falls within the normal range for male patients (35-48 mm Hg). The PaO₂ level is 85 torr, also within the normal range. The HCO⁻₃ level is 24 mEq/L, within the normal range (22-29 mM). These results suggest that the patient's respiratory system is functioning adequately and there is no evidence of acidosis or alkalosis.

Based on the stable vital signs and ABG results, the most appropriate recommendation would be to D. Extubate the patient. Extubation is the process of removing the endotracheal tube once the patient is able to maintain adequate oxygenation and ventilation on their own. Since the patient's ABG results and vital signs are stable, it indicates that they are capable of breathing spontaneously without the need for mechanical ventilation.