Jump to content
DartmouthDave

Bad Lungs Bad Transfer

Recommended Posts

Old thread, but.... sounds like this kid is headed for v/v ecmo at the big house. Clearly unstable for transport currently.

Optimize ventilation... how much of a leak is coming from the chest tubes at current tidal volume? This is not a situation where normal tidal volumes based on predicted body weight will do. No mention of peep, but 6- 10 for starters with total paralysis.... lots of things to unpack there, but moving on...

If she doesn't have an A line, she needs one and pulse pressure variation guided volume replacement started. She's in shock. Potassium should be antagonized with a gram of calcium chloride. K will probably fall with volume resuscitation, tho, no mention of glucose, a little insulin if appropriate. Norepi as required once adequate volume resuscitation underway for MAP of 65.

The CO2 is the least of my worries. Optimize oxygenation and perfusion and transport.

Edited by Off Label

Share this post


Link to post
Share on other sites
This thread is quite old. Please consider starting a new thread rather than reviving this one.

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...