A 30 week gestational age neonate is currently on the follow…
A 30 week gestational age neonate is currently on the following settings: Jet Ventilation with a rate of 420/min (7 Hz), I-time .02 seconds, PIP 22cmH20, conventional ventilation setting of SIMV 20/min, fi02 .30, PEEP 5cmH20. CXR shows atelectasis of the right lung along with a broncho pleural fistula. A chest tube is in place. ABG’s reveal pH 7.21, paC02 70 mmHg, pa02 60 mmHg, HC03- 24meq/L. Which of the following changes would you recommend? I. Decrease rate to 360 to allow more time for exhalation II. Increase backup SIMV rate to 24/min III. Decrease backup SIMV rate to 4/min IV. Increase PEEP to 8 cmH20 V. Increase the amplitude to 24 cmH20