Pulmonary Problem Solving III


Case Two

patient illustration

History

[Continuation of Case One: JV] Two hours after initiation of NIV, JV appears to be reasonably comfortable, occasionally dozing. Breath sounds reveal wheezes on exhalation throughout. Arterial blood gases drawn while on IPAP 10, EPAP 5, FiO2 50% are:

pH: 7.30; PaO2: 110
PaCO2: 69; SaO2: 100%
HCO3: 33; Hgb: 16.4