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
damrcngrl95 207 Posts Sep 27, 2014 You can bring down high CO2s with higher volumes, increased respiratory rate, and longer expiratory times. If the patient is maxed out on volume then the next step would be to adjust respiratory times. This will increase their expiratory minute volumes and blow off more CO2.
babyNP., APRN 1,921 Posts Specializes in NICU. Has 15 years experience. Sep 27, 2014 Have you learned about acid/base balance yet? What would a patient present with in respiratory acidosis?
edmia, BSN, RN 827 Posts Specializes in Emergency, ICU. Has 10 years experience. Sep 27, 2014 Go to your A&P book and review the physiology of acid/base balance.What builds up with acidosis?
fakebee 120 Posts Sep 28, 2014 I can promise you that if your patient's bicarbonate is 7, there's a 99 percent chance he's not in respiratory acidosis. Please provide the rest of the ABG values.
Regina518 10 Posts Sep 28, 2014 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.
Regina518 10 Posts Sep 28, 2014 . Ms. C is on a mechanical ventilator set on assist-control of 14, respiratory rate of 28, volume 650, oxygen 40%, and a positive end-expiratory pressure (PEEP) of 5
sevo87 20 Posts Specializes in SI/CV ICU and ER. Has 5 years experience. Sep 28, 2014 The vent is acting as a temporary fix for the acidosis. The underlying problem is what needs to be fixed, a lot of intensivists don't like to give the patient exogenous bicarbonate because it really skews what is wrong. The problem could be something as simple as dehydration, or it could be something much more complex like renal failure. The short answer is they are blowing off c02 as a temporary fix.
Esme12, ASN, BSN, RN 4 Articles; 20,908 Posts Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 43 years experience. Sep 28, 2014 . Ms. C is on a mechanical ventilator set on assist-control of 14, respiratory rate of 28, volume 650, oxygen 40%, and a positive end-expiratory pressure (PEEP) of 5Looking at these settings....the machine is set at assist control of 14, so the machine will give exactly 14 breaths per minute, however the patient is over breathing at a total rate of 28 breaths per minute. A +5 of peep is really noting it just "removes" (compensates for) the dead space of the vent tubing.The overall respiratory rate is high but the vent is set at 14....why is the patient breathing more/over the vent? .....to compensate for metabolic acidosis.5.5 Metabolic Acidosis - Compensation
