A 56-year-old male with advanced idiopathic pulmonary fibros…

A 56-year-old male with advanced idiopathic pulmonary fibrosis presents to the ICU in respiratory distress. He is put on high flow nasal cannula with 50 L flow, 80% FiO2. ABG obtained has a pH significant for 7.32, PaO2 of 80 mm Hg, PaCO2 of 20 mm Hg, HCO3 of 30. Given his underlying disease, what is the primary physiological aberration leading to the patient’s hypoxemia?

A 42-year-old obese female with OSA, diabetes mellitus, and…

A 42-year-old obese female with OSA, diabetes mellitus, and hypertension is admitted for community-acquired pneumonia. After multiple attempts, she is emergently intubated with ET tube size 8.5. She has been intubated for 7 days and today she has tolerated the spontaneous breathing trial. What is the next step?