Pulmonary Problem Solving III

Case Two

Patient Chart
[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

Heart Rate:
Blood Pressure: /


Which of the following would be another appropriate intervention to make at this time?