An 18-year-old male, 80 kg, presented in diabetic ketoacidosis complicated by a prolonged generalised seizure. He has been intubated for airway protection and is sedated and mechanically ventilated while awaiting ICU review.
An arterial blood gas taken on FiO2 1.0 is shown below.
| Test |
Result |
Reference range |
| FiO2 |
1.0 |
|
| pH |
7.02 |
7.35-7.45 |
| PCO2 |
60 mmHg |
30-40 |
| PO2 |
200 mmHg |
60-100 |
| HCO3 |
11 mmol/L |
22-31 |
| Base excess |
15 |
-3 to +3 |
| Haemoglobin |
155 |
120-165 |
| Sodium |
125 mmol/L |
135-145 |
| Potassium |
6.5 mmol/L |
3.5-5.0 |
| Chloride |
86 mmol/L |
98-110 |
| Glucose |
35 mmol/L |
3.5-5.5 |
| Lactate |
2.5 mmol/L |
<2 |
Complete the requested calculations and state the clinical implication for each.
(Marked out of 10.0)
/ 10
He is on SIMV volume control with FiO2 1.0, tidal volume 400 mL, rate 12/min, PEEP 5 cmH2O, and pressure support 5 cmH2O. Spontaneous efforts are triggering high-pressure alarms. Describe your ventilation strategy and endpoints.
(Marked out of 5.0)
/ 5
Total Score: 0 / 15
Percentage: 0%
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