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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