Why would a patients respiratory rate be set at 28 on a mechanical ventilator?

[Regina518]

Mechanical ventilators are usually set between 12-16 breaths per minute but one patient in a case study I am working on, has her ventilator set at 28.

The Patient Bicarbonate level is low at 7 and is in respiratory acidosis. Just wondering. I have not been to a ICU floor nor can I find the answer in the book.

Just wondering why would they set a patients respiratory rate so high on a mechanical ventilator.

please help

confused nursing student

[Esme12, ASN, BSN, RN]

http://fitsweb.uchc.edu/student/selectives/TimurGraham/Compensatory_responses_metabolic_acidosis.html

[NICUmiiki, DNP, NP]

The vent is not set at 28. It is set at 14. The vent allows the patient to breath spontaneously, which she is doing at a rate of 28.

[KelRN215, BSN, RN]

But her bicarbonate is low. so a higher resp rate on the ventilator would lower it even more according to your answer, no? Also i meant metabolic acidosis.

No, it wouldn't. Bicarb levels are controlled by the kidneys, CO2 levels are controlled by the lungs. The increased respiratory rate wouldn't have a direct effect on the HCO3 level, it would lower the CO2 to compensate for the acidotic state.

[sevo87]

No, it wouldn't. Bicarb levels are controlled by the kidneys, CO2 levels are controlled by the lungs. The increased respiratory rate wouldn't have a direct effect on the HCO3 level, it would lower the CO2 to compensate for the acidotic state.

Theoretically yes it would, the vent is blowing off her c02 which will make her more alkalotic, the kidneys if they are working properly will decrease bicarb production to compensate for this. That is assuming her kidneys are working properly and that the vent is blowing off enough c02 to not only fix the acidosis but to shift her the other way to alkalosis.

[StudentOfHealing]

But her bicarbonate is low. so a higher resp rate on the ventilator would lower it even more according to your answer, no? Also i meant metabolic acidosis.

CO2 + H2O = H2CO3 aka Carbonic ACID.

The lungs are THE fastest organ at removing acids.

Your kidneys will take HOURS and cannot remove as many acids as your lungs can in a short amnt of time.

***Especially if the etiology of the metabolic acidosis is renal.

So think about it this way. Removing acids will maintain some stability while the ROOT CAUSE is fixed.

Her bicarb being low means she's in met acdosis. There's too many acids. Bicarb is the buffer.

So you may ask: "Why is there a low bicarb with metabolic acidosis?"

Because: All the bicarb is being used up to neutralize the build of acids so th bicarb is low.