Blood gases

Question 1

What do we mean by permissive hypercarbia in the NICU, in terms of numbers on the blood gas, and why do we allow it?

Answer 1

Allow it because it maintains cerebral perfusion.

Acceptable numbers: pH 7.20s, CO2s 50s to mid 60s

Question 2

Normal arterial cord pH

Answer 2

7.23 to 7.33

Question 3

Cord ABG normal PaO2

Answer 3

12 -24

Question 4

Cord ABG normal PaCO2

Answer 4

roughly 40 to 58

Question 5

Cord ABG normal HCO3

Answer 5

14 to 22

Question 6

At 1 hour of life, normal pH or an ABG is

Answer 6

7.26 to 7.49

Question 7

At 1 day of life, normal pH on an ABG is

Answer 7

7.29 to 7.45

Question 8

Normal PaCO2 on an ABG anywhere from birth to 1 day of life and beyond:

Answer 8

27 to 40

Question 9

Normal PaO2 on an ABG at 1 day of life

Answer 9

54 to 95

Question 10

Normal PaO2 on an ABG at 1 hour of life

Answer 10

55 to 80

Question 11

What is SIMV?

Answer 11

= synchronized intermittent mechanical ventilation (syncs vent with infant’s breaths)

Question 12

Delta p means

Answer 12

pressure support

Question 13

Normal tidal volume for infants

Answer 13

Preemies under 32 weeks: 4-5 mL/kg

Over 32 weeks: 5 to 6 ml/kg

Question 14

On SIMV, typically set RR to

Answer 14

20 to 45 bpm

Question 15

Normal pressure support to start with

Answer 15

6 to 8

occasionally up to 10

Question 16

These two things (settings) affect oxygenation:

Answer 16

FiO2 and PEEP

Question 17

If you increase PEEP, you are trying to improve

Answer 17

oxygenation

Question 18

To increase PaO2, you could do either of these two things:

Answer 18

increase FiO2

or increase PEEP

Question 19

These two things (settings) affect CO2

Answer 19

RR and tidal volume

Question 20

Minute ventilation =

Answer 20

RR x tidal volume

Question 21

Increasing mean airway pressure increases

Answer 21

oxygenation

Question 22

On HFOV, how much should you increase MAP by at a time?

Answer 22

0.5 to 1

Question 23

Delta P on HiFi affects ventilation or oxygenation?

Answer 23

ventilation

adjust by 2 at a time

Question 24

When would you decrease Hz?

Answer 24

If not oxygenation well (for more, smaller breaths)

Question 25

Start Hz at

Answer 25

10

keep within range of 8 to 12