Question

A post-operative patient is receiving mechanical ventilation in the ICU at the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 mm Hg and the SpO2 is 90%. The patient is alert and oriented with stable vital signs. Which of the following should the respiratory therapist recommend?

A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely.

Answer 1

To address the patient's mechanical ventilation settings with a PvO2 of 35 mm Hg and SpO2 of 90%, it is best to continue close monitoring since the patient is stable and alert. Adjustments should be made only after a thorough clinical evaluation to identify the underlying cause of the low PvO2 and SpO2 values.

Step-by-step explanation:

The question involves adjusting the mechanical ventilation settings for a post-operative patient in the ICU who is showing a mixed picture of oxygenation parameters with a PvO2 of 35 mm Hg and SpO2 of 90%. Considering the patient is alert, oriented, and has stable vital signs, the best recommendation would be to closely monitor the patient. Neither increasing the fractional inspired oxygen (FIO2) nor decreasing the positive end-expiratory pressure (PEEP) can be justified based on the information provided. Introducing diuretic therapy without any indication of fluid overload or heart failure is not warranted. Adjustments to mechanical ventilation should only be made after thorough clinical evaluation and determination of the cause of the low PvO2 and SpO2.