A patient with ARDS has deteriorating oxygenation associated with a new infiltrate on chest…

A patient with ARDS has deteriorating oxygenation associated
with a new infiltrate on chest radiograph. Gram-negative bacterial
ventilator-associated pneumonia is strongly suspected, and FB is deemed
necessary before adjusting antibiotic therapy because the suspected pathogen is
likely to be multidrug resistant. The patient has a high minute ventilation
demand of 13 L/min to maintain a pH of 7.40 and PaCO2 of 40 mm Hg. The patient
has sepsis and currently requires norepinephrine at 12 mcg/min to maintain a
mean arterial pressure of 65 mm Hg. The physician decides that during FB, a pH
of 7.25 would be tolerable for the estimated procedure time of 10 minutes. The
RT is asked if there is a clinical formula to estimate what rise in PaCO2
would likely produce the target minimum pH. In addition, the RT is asked to
estimate the minimum minute ventilation needed during FB that would likely
maintain pH at 7.25

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