Review the case study and consider the perspectives discussed within this module that are impacting the patient. You will review the case study and apply your understanding of content from this weeks lecture and reading material to communicate ideas about the case. Apply concepts you've learned that pertain to cardiac output, venous return and their regulation to your discussion posts.
Case Study:
A 65-year-old female with a history of cardiovascular disease, diabetes, and 30 pack-year history of smoking is being admitted. She had no fever, chills, change in her chronic cough or dyspnea. She was able to participate in her rehabilitation activities and was progressing as expected. On the day of admission, the patient complained of acute onset of dyspnea. She was found to be tachypneic and cyanotic with a respiratory rate of 38. The exam revealed crackles on the right and diminished breath sounds on the left. She was transferred to the closest hospital where she was emergently intubated and transferred to the regional medical center.
The patient remained intubated and transferred to the CVICU following an myocardial infarction. Placement of an arterial line, for continuous blood pressure monitoring, and a pulmonary artery catheter for cardiac output monitoring was done without complication. Several days later she was developing signs of ARDS. :
Time | Rate | Tidal Volume | FIO2 | PaO2 | PEEP | PIP/Plat | CO |
15:33 | 22 | 500 | 1.0 | 90 | 12 | 38/34 | 7.2 |
18:16 | 24 | 500 | 1.0 | 80 | 15 | 42/39 | 5.9 |
21:20 | 27 | 500 | 1.0 | 60 | 18 | 48/45 | 4.7 |