A 45-year-old male patient with a severe exacerbation of chronic obstructive pulmonary disease (COPD) is being prepared for invasive mechanical ventilation. After initiating ventilation with a volume control mode, the patient's arterial blood gas (ABG) shows PaCO2 is 55 mmHg (high), PaO2 is 70 mmHg (low), pH is 7.25 (acidotic). What should be your next step in managing this patient's ventilation settings?
In this scenario, the patient's ABG indicates respiratory acidosis and hypoxemia, suggesting inadequate ventilation and oxygenation. Increasing the tidal volume can help reduce PaCO2 by enhancing CO2 elimination, improving the pH. Adjusting the respiratory rate and FiO2 may also be necessary depending on subsequent ABG results.
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Resuscitation Principles
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