A patient was found down after an unknown, but believed prolonged over 3-6 hrs, unconscious. EMSd to hospital, intubated. Severe metabolic acidosis, with initial pH of 7.1, CO2 70s, pO2 60s on 100% FiO2. Obvious aspiration pneumonia. Sedated with propofol, PRVC rate of 24. Despite adequate comfort sedation, patient respirations averaging 30-45 BPM. Low dose bicarb gtt in use.
It was suggested to increase patient sedation to the point of overcoming respiratory drive. Just wondering if this is common practice. I thought allowing the patient to remain tachypnic would reduce CO2. Also thinking that oxygenation would not be responsive to reduced resp rate as the patient was not 'bucking' or fighting the ventilator breaths.
Do you generally allow the patient to breath instinctively, or block spontaneous respirations in initial recovery?
I am new in dealing with Med ICU patients and would appreciate any education and insight!