Blood gases Flashcards
What do we mean by permissive hypercarbia in the NICU, in terms of numbers on the blood gas, and why do we allow it?
Allow it because it maintains cerebral perfusion.
Acceptable numbers: pH 7.20s, CO2s 50s to mid 60s
Normal arterial cord pH
7.23 to 7.33
Cord ABG normal PaO2
12 -24
Cord ABG normal PaCO2
roughly 40 to 58
Cord ABG normal HCO3
14 to 22
At 1 hour of life, normal pH or an ABG is
7.26 to 7.49
At 1 day of life, normal pH on an ABG is
7.29 to 7.45
Normal PaCO2 on an ABG anywhere from birth to 1 day of life and beyond:
27 to 40
Normal PaO2 on an ABG at 1 day of life
54 to 95
Normal PaO2 on an ABG at 1 hour of life
55 to 80
What is SIMV?
= synchronized intermittent mechanical ventilation (syncs vent with infant’s breaths)
Delta p means
pressure support
Normal tidal volume for infants
Preemies under 32 weeks: 4-5 mL/kg
Over 32 weeks: 5 to 6 ml/kg
On SIMV, typically set RR to
20 to 45 bpm
Normal pressure support to start with
6 to 8
occasionally up to 10
These two things (settings) affect oxygenation:
FiO2 and PEEP
If you increase PEEP, you are trying to improve
oxygenation
To increase PaO2, you could do either of these two things:
increase FiO2
or increase PEEP
These two things (settings) affect CO2
RR and tidal volume
Minute ventilation =
RR x tidal volume
Increasing mean airway pressure increases
oxygenation
On HFOV, how much should you increase MAP by at a time?
0.5 to 1
Delta P on HiFi affects ventilation or oxygenation?
ventilation
adjust by 2 at a time
When would you decrease Hz?
If not oxygenation well (for more, smaller breaths)
Start Hz at
10
keep within range of 8 to 12
