Hfov adult case study
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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 – Adult Case Study

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Hfov adult case study

HFOV – Adult Case Study


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


Admission

Admission


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


Abg s

ABG’s


Abg s1

ABG’s


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


Abg s2

ABG’s


Abg s3

ABG’s


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


Pre hfov 4 21 11 00 hrs

Pre HFOV – 4/21 – 11:00 hrs


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


Abg s4

ABG’s


Abg s5

ABG’s


Abg s6

ABG’s


Abg s7

ABG’s


Hfov 4 22 04 39 hrs

HFOV – 4/22 – 04:39 hrs


Abg s8

ABG’s


Hfov 4 23 10 26 hrs

HFOV – 4/23 – 10:26 hrs


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


Abg s9

ABG’s


Pcv 4 24 07 58 hrs

PCV – 4/24 – 07:58 hrs


Abg s10

ABG’s


Abg s11

ABG’s


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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