Do not use too many sources on it. BB Rogers You are working in a level III NICU and receiving shift report. BB Rogers is a 41-wG newborn, now 2 days old. He was born via cesarean section, with Apgar scores of 3 and 6. An echocardiogram results in a diagnosis of idiopathic PPHN, and he not being maintained on SIMV, respiratory rate of 35 breaths/min, PIP of 25 cm H2O, PEEP of 6 cm H2O, TI of 0.5 seconds, and FiO2 of 0.90. Paw is 11.5 cm H20. Most current ABG values are pH of 7.37, PaCO2 of 44 mm Hg, HCO3 of 25.1 mEq/L, and PaO2 of 68 mm Hg. His HR is 125 bpm, BP is 50/30 mm Hg, spontaneous RR is 10 breaths/min, pre-SpO2 is 98%, and post SpO2 is 93%. Do you think this patient is being well managed by his current therapy? Why or why not? The physician would like to change BB Rogers to HFOV. If that does not serve to improve ventilation and oxygenation, he would like to initiate iNO. What would you suggest as initial settings for HFOV? Would you recommend iNO for this patient? Why or why not?
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