Ventilating Patient with Refractory Hypercarbia: Use of APRV Mode
A 70-year-old patient referred to our critical care unit with the diagnosis of type II respiratory failure with shock. Patient was a known case of COPD for last 20 years. His chest radiology revealed bilateral infiltrates. Patient was managed conservatively in the form of antibiotics, vasopressor...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7016/16380_CE[Ra1]_F(AK)_PF1(VIAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | A 70-year-old patient referred to our critical care unit with the diagnosis of type II respiratory failure with shock. Patient was a known case
of COPD for last 20 years. His chest radiology revealed bilateral infiltrates. Patient was managed conservatively in the form of antibiotics,
vasopressor and ventilatory support with SIMV/VC mode. After ventilation with SIMV/VC mode for half an hour his blood gases revealed
increasing PaCO2
levels. The same result was obtained with PC mode and ASV and his PaCO2
level reached above 170 mmHg.
Then APRV mode was tried with modified settings. The results obtained were satisfactory and in next 24 hours PaCO2
decreased to
<66mmHg along with an increasing P/F ratio. APRV is the not recommended as primary mode of ventilation in COPD but in resistant
cases it can be helpful as it improves alveolar recruitment and pressure support is added to reduce hypercapnia. |
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| ISSN: | 2249-782X 0973-709X |