A patient with acute hypoxemic respiratory failure is receiving NIV via nasal mask with a…

A patient with acute hypoxemic respiratory failure is
receiving NIV via nasal mask with a noninvasive ventilator. The ventilator is
delivering PSV with peak inspiratory pressure set at 12 cm H2O and
end expiratory pressure set at 5 cm H2O. O2 at 6 L/min is
flowing into the nasal mask. After 40 minutes on NIV, the patient continues to
have signs of respiratory distress (dyspnea, tachypnea with respiratory rate
30, heart rate 120 beats/min, SpO2 88%, and cyanosis). The patient
is having difficulty keeping his mouth closed, and there is a large air leak as
a result. An arterial blood gas was drawn, and PaO2 is 50 mm Hg

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