A 200 lb post operative open heart surgery male patient with a 30 year history of cigarette smoking (1 pack a day) is on a ventilator in the Cardiopulmonary Surgery unit at Albany Medical Center

A 200 lb post operative open heart surgery male patient with a 30 year history of cigarette smoking (1 pack a day) is on a ventilator in the Cardiopulmonary Surgery unit at Albany Medical Center. The operation was successful yet this patient cannot come off of the ventilator.  The ventilator high pressure alarm has been going off repetitively for the last 2 hours.  Please refer to the parameters provided below to answer the case study questions.

Vent. Check-Day 1                                        Vent Check-Day 2

Set V_T             =          500 ml                         Set V_T             =          500 ml

Set f                =          10                                Set f                =          10

Actual f                        =         10                                Actual f           =          15

Spont Vt           =         none                             Spont Vt          =         250ml

FIO₂                =          .40                               FIO₂                =          .40

PEEP               =          5 cmH₂0                      PEEP               =          5 cmH₂0

Plateau            =          20 cmH₂0                    Plateau            =          20 cmH₂0

                PIP                  =          30 cmH₂O                   PIP                  =          45 cmH₂O

Peak Flow       =          65 Lpm                        Peak Flow       =          65 Lpm

Volume lost    =           0                                Volume Lost   =            0

Calculate C_s for Day 1 and 2:

Calculate C_D for Day 1 and 2:

Calculate Raw for Day 1 and 2:

Calculate V_E for Day 1 and 2:           .

Calculate V_A for Day 1 and 2:

What area of the lung is having difficulty? How do you know this?

What treatment might be helpful?