Thursday, August 25, 2016

Ventilators III

This unresponsive patient was intubated for airway protection.

Challenge: What is your goal with the ventilator?

Image shown under Fair Use.


RaH said...

This patient should receive brain protective ventilation... a slight hyperventilation with decreased etCO2 could be used (as described by ALS and ACLS)

Craig Chen said...

Ventilators III

The CT shows diffuse cerebral edema with effacement of sulci, ventricles, and basal cisterns. The patient is likely herniating. The goal with ventilation is mild hypercapnia which can decrease intracranial pressure, usually to a PaCO2 of 30-35. It is not recommended to hyperventilation beyond that because extreme hypocapnia can cause cerebral ischemia.