A 4 day old, 35-week gestation male with symptoms of respiratory distress syndrome is on 10 cm H2O nasal CPAP with an FIO2 of 0.30. His vital signs, appearance, and fluid output have been stable for 12 hours. Umbilical artery blood:.

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The complete question is:

A 4 day old, 35-week gestation male with symptoms of respiratory distress syndrome is on 10 cm H2O nasal CPAP with an FIO2 of 0.30. His vital signs, appearance, and fluid output have been stable for 12 hours. Umbilical artery blood gas results are as follows:

pH = 7.43

PaCO2 = 42 mm Hg

HCO3 = 27 mEq/L

BE = +1

PaO2 = 129 mm Hg

SaO2 = 99%

Based on this information, you would recommend which of the following?

A. Maintain the present therapy and monitor the infant.

B. Discontinue CPAP and increase the FIO2 to 0.40.

C. Decrease CPAP to 5 cm H2O.

D. Decrease the FIO2 to 0.21.

C. Decrease CPAP to 5 cm H2O.

Explanation:

The given data shows improvment in the baby. The problem in baby as of the data is only , the hyperoxemia (PaO2 = 129 mm Hg) in the infant.

So the concern is to lower the PaO2, it can be done either by decreasing  the CPAP or decreasing the FIO2. As FIO2 is in safe range, so decreasing the CPAP will be chosen due to the stress placed on the heart and 0.28 FIO2 will be easier to wean.

Hence, the correct answer is C."decrease CPAP to 5 cm H2O"