A 70 year old is is intubated and ventilated post-laparotomy. He has CSL running @60ml/hr, with an NGT on suction with continuing high output. His ABG shows an appropriate pO2, pCO2 32, pH 7.66, Na 144, K 3.5, Cl 76. He has a normal creatinine and raised urea. How should you improve his acid base status? (Had a very very very long stem, with very long answers, but this was the gist, and I'm pretty confident with the answers except the first 2 fluid options).
Wähle eine der folgenden:
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Leave minute ventilation unchanged, (?leave fluids unchanged), commence PPI
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Leave minute ventilation unchanged, (?leave fluids unchanged), commence acetazolamide
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Increase minute ventilation, change IVF to normal saline, commence PPI
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Increase minute ventilation, increase the fluid rate, commence acetazolamide
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Increase minute ventilation, leave fluids unchanged, commence acetazolamide