Based on the information you gathered so far, you know your patient’s lung mechanics are as follow:
[az_accordion_section] [accordion title=”Compliance poor at 35 mL/cmH2O” id=”acc-1″] This seems to fit with the chest X-Ray done after the patient was intubated that shows diffuse parenchymal infiltrates compatible with a multi-lobar and severe pneumonia. You then start him on large-spectrum antibiotics until results of cultures arrive and make sure to avoid a positive fluid balance. [/accordion] [accordion title=”Resistance slightly elevated at 13 cmH2O/L/s” id=”acc-2″] The airway of a normal healthy person usually results in a resistance of 2.5cmH2O/L/s to flow, but once intubated, the ETT usually sets the resistance at around 5-10 cmH2O/L/s. You find his a little bit more than what you would expect for a new tube and since you confirmed it is not blocked by any secretions by succionning, you conclude it is not at the equipment level that the high resistance is arising from. You then listen to your patients chest and noticed that he has some wheezing to explain the higher than normal resistance and you start nebulized ß-agonists.
However, 4h after his admission to ICU, you are called by the bedside nurse because she is worried. [/accordion] [/az_accordion_section]