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HFOV – Adult Case Study. HFOV Case Study - Admission. 46 yo unrestrained female MVA Fractures Rt radial, ulna, fibula Lt ankle RML contusion CT head and c-spine negative Pt c/o left chest pain and sedated with morphine and diprivan VSS. Admission. HFOV Case Study.

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Hfov case study admission
HFOV Case Study - Admission

  • 46 yo unrestrained female MVA

  • Fractures

    • Rt radial, ulna, fibula

    • Lt ankle

  • RML contusion

  • CT head and c-spine negative

  • Pt c/o left chest pain and sedated with morphine and diprivan

  • VSS



Hfov case study
HFOV Case Study

  • Pt transported to OR for fx repair – VSS

  • 24 hours later pt developed respiratory distress

  • CXR revealed diffuse patchy infiltrates




Hfov case study1
HFOV Case Study

  • Pt placed on 1.0 mask CPAP +10

  • Pt increasingly agitated,  SOB, use of accessory muscles

  • Pt subsequently intubated

    • 1.0/AC/650/14 (no PEEP)

    • SaO2 78%

  • Pt sedated and paralyzed

  • PEEP  10 cmH2O




Hfov case study2
HFOV Case Study

  • Although ABG’s improved, pt became increasingly agitated

    • RR  30’s

    • High pressure limit

    • BP, HR 

    • SaO2  40’s



Hfov case study3
HFOV Case Study

  • Pt transitioned to HFOV

    • MAP 28, Hz 5, Amp 70, I time 33%, FiO2 1.0

    • Pt paralyzed and sedated, TcCO2 76-78

    • ABG 7.13/87/159

    • Amp  86, dopamine and sedation weaned

    • ABG 7.21/65/116

    • FiO2  .70, Amp  98

    • ABG 7.33/50/101









Transition to cmv
Transition to CMV

  • PCV

    • PIP = 30cmH2O

    • Vt = 680 (wt 75kg)

    • FiO2 = .60

    • PEEP = 5cmH2O

  • ABG

    • 7.47/44/62

  • PCV

    • PIP  20cmH2O, PEEP  8cmH2O






Hfov case study4
HFOV Case Study

  • Pt extubated on 4/29 and placed on 40% HHM, bronchodilator therapy and incentive spirometry

  • Pt discharged to rehab facility on 5/2


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