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Following an automobile accident, a 19 year old male is admitted to the hospital. He has sustained
multiple burns, severe pulmonary contusions, and has aspirated. He is admitted to the ICU, intubated and
placed on a ventilator with initial settings of A/C 500 x 16 1.0 +10 PEEP. A PAC is inserted and ABG’s
are drawn after 30 minutes of mechanical ventilation. CXR reveals correct placement of the ETT and
PAC the presence of bilateral infiltrates. pH = 7.53
PaCO2 = 35 mmHg
PaO2 = 33 mmHg
HCO3 = 26 mEq/L
Part 1: Patient's actual systemic vascular resistance (SVR) was approximately 1173.04 dynes/sec/cm5. (Say normal range is between 900 and 1400)
Part 2: Patient's pulmonary vascular resistance (PVR) was approximately 364.4 dynes/sec/cm5 (Say normal range is in the range of 50-250)
Part 3: Patients actual arterial Oxygen Content (CaO2) was 14.72 mL/dL. (Say normal range is 17-20 mL/dL)
Part 4: Patient's actual Venous Oxygen (CvO2) was 10.96 mL/dL. (Say normal range is 12-15 mL/dL)
Part 5: Patient's actual Arterial-Venous Oxygen Content Difference (Ca-Vo 2) was 3.76 mL/dL. (Say normal range is 3.5-5 mL/dL)
Part 6: Patient's actual oxygen extraction ratio (O2ER) is 26% (Say normal range is 20-28%)
What is clinically happening to the patient?
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