Page 704 - Clinical Application of Mechanical Ventilation
P. 704
670 Chapter 19
TABLE 19-2 Serial Vital Capacities and Maximum Inspiratory Pressure
Vent Day f (/min) FVC (L) MIP (cm H O)
2
1 18 1.03 230
2 22 1.30 230
3 28 1.11 233
4 32 1.13 236
5 34 1.06 235
6 30 1.45 239
7 28 1.42 236
8 28 1.21 250
9 24 1.40 238
10 20 1.80 234
11 24 1.70 238
12 24 1.60 240
13 18 1.65 243
14 18 2.10 246
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continued to improve over the latter half of her hospitalization, and after 14 days
of mechanical ventilation she exhibited evidence that she could support her own
respiratory status without assistance from the ventilator.
Patient Management
The management strategy for botulism consists mainly of supportive measures, as
The management she was mechanically ventilated for 14 days. Patient supportive measures included
strategy for botulism
consists mainly of supportive turning the patient from side to side, assisting the patient to an Orthochair at the
measures. bedside, and using medications for comfort. Her nutritional status was maintained
through I.V. fluids alone. The patient continued to improve, and on the 7th ventila-
tor day she was transferred to a subacute unit for further recovery and monitoring.
Key Medications
The patient’s lungs remained diminished but clear throughout. There were no ab-
normal secretions when she was suctioned. However, vigorous pulmonary toilet
was done to prevent lung pathology while in the step-down ICU. She was treated,
prophylactically, on small-volume nebulizer therapy with 0.5 mL of 0.5% albuterol
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