Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So currently, we are working with a client who has their 68-year-old mother in intensive care after a pneumonia . And she got intubated and she has also been diagnosed with lung cancer, about four months ago. Stage 4 lung cancer, I should say.
So now, she had a tracheostomy. She’s awake, but she can’t wean off the ventilator because she’s deconditioned. Because of all her eight weeks in ICU now, and they haven’t mobilized her. And as I keep always saying, you can’t wean a patient off the ventilator without mobilization. It’s just not happening.
But then, there is another issue that with a stage 4 lung cancer. It’s an extra challenge layered on top of everything else to wean her off the ventilator.
And here is what I want to breakdown today.
You got to look for volumes. When someone is on a ventilator, you got to look for what’s called tidal volumes. And you got to look for how many mls per breath is someone breathing.
So, to illustrate that, there is a formula that somebody should breathe 7 to 10 mls per kilogram. So, if someone for simplicity is a hundred kilograms, they should be approximately breathing 700 to 1000 mls per breath.
Now, this lady happens to be around a hundred kilogram, and she’s only breathing around 400 mls when she is in a controlled setting. And she’s only breathing about 200 to 250 mls if she is breathing spontaneously in CPAP and pressure support. So that’s way too low. Even though her blood gases, her arterial blood gases have been okay, it still doesn’t seem to be enough to take her to the next step to wean her off the ventilator.
So, it’s really important that you watch out for the tidal volumes in mls. And again, a formula is seven to 10 mls per kilo per breath.
That is my quick tip for today.
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This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.