1. HFOV – Adult Case Study

2. 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

3. Admission

4. HFOV Case Study Pt transported to OR for fx repair – VSS 24 hours later pt developed respiratory distress CXR revealed diffuse patchy infiltrates

5. ABG’s

7. 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 cmH 2 O

8. ABG’s

10. HFOV Case Study Although ABG’s improved, pt became increasingly agitated –RR  30’s –High pressure limit –BP, HR  –SaO2  40’s

11. Pre HFOV – 4/21 – 11:00 hrs

12. HFOV Case Study Pt transitioned to HFOV –MAP 28, Hz 5, Amp 70, I time 33%, FiO2 1.0 –Pt paralyzed and sedated, TcCO 2 76-78 –ABG 7.13/87/159 –Amp  86, dopamine and sedation weaned –ABG 7.21/65/116 –FiO 2 .70, Amp  98 –ABG 7.33/50/101

13. ABG’s

17. HFOV – 4/22 – 04:39 hrs

18. ABG’s

19. HFOV – 4/23 – 10:26 hrs

20. Transition to CMV PCV –PIP = 30cmH 2 O –Vt = 680 (wt 75kg) –FiO 2 =.60 –PEEP = 5cmH 2 O ABG –7.47/44/62 PCV –PIP  20cmH 2 O, PEEP  8cmH 2 O

21. ABG’s

22. PCV – 4/24 – 07:58 hrs

23. ABG’s

25. 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