[confusionabounds]

Okay, here is a dumb question that I have recently become confused about as i am in clinicals. if my pt. has a low BP, what can i do respiratory wise to raise it? (i know i would do many other things first, but this is like a last ditch thing before pressors) would increasing my resp. rate on my vent. raise the bp? (due to neg. pressure of each respiration 'pulling' blood from lower body to increase return to heart) or would it lower my bp due to blowing off too much co2? I know, i know, a simple and probrably stupid question, but i can't remember and can't seem to find it in my literature. any ideas? (and please don't tell me 'look it up' - it is not something someone has asked, it just popped into my head today and i couldn't remember and can't seem to find the answer) thanks for any responses.

[hrtprncss]

back off on the peep

[confusionabounds]

Originally Posted by hrtprncss

back off on the peep

not using any peep other than physiologic. my theoretic low bp is not due to the vent itself. my question is what adjustment to the vent(tidal volume, resp. rate, etc) can i alter to affect my bp?

[hrtprncss]

besides watching the peak pressures to prevent hypotension not really sure, decreasing rr will lead to an increase in the icp which would lead to the body compensating by increasing the map to keep the cpp at range but that's not really a good idea

[sproutsfriend]

Originally Posted by confusionabounds

would increasing my resp. rate on my vent. raise the bp? (due to neg. pressure of each respiration 'pulling' blood from lower body to increase return to heart) or would it lower my bp due to blowing off too much co2?

The vent delivers positive pressure ventilation so the negative pressure you describe would not be present. I'd let the CO2 creep up to stimulate catecholamine release which should raise HR and increase SVR.

[hrtprncss]

there u go some kind of permissive hypercapnia lol increasing the cathecolamines and increasing the icp thus leading to the body's compensatory response

[Businessman]

Originally Posted by hrtprncss

there u go some kind of permissive hypercapnia lol increasing the cathecolamines and increasing the icp thus leading to the body's compensatory response

Low BP in a healthy individual is compensated automatically by the body (baroreceptors, RAAS, SNS, adrenal glands or epi).
Low BP in an unhealthy indiv. goes hand in hand with a bad heart, therefore stimulating the heart by RR alone it's a long shot. The way of catecholamines is a very round-about way, and the above mentioned items will fix the BP first.