If a patient is receiving supplemental oxygen at FIO2 0.6 and has an arterial blood gas showing a PaO2 of 69 mm Hg, what is the best recommendation?

• A. Place the patient on a non-rebreathing mask
• B. Place the patient on CPAP
• C. Place the patient on a partial rebreathing mask
• D. Increase FIO2 to 0.8 via cool aerosol mask

Answer: (B)

The best recommendation in this scenario is to place the patient on Continuous Positive Airway Pressure (CPAP). This choice is appropriate because a patient receiving supplemental oxygen at a fraction of inspired oxygen (FIO2) of 0.6 with a PaO2 of only 69 mm Hg indicates that despite a relatively high level of supplemental oxygen, the patient is still experiencing significant hypoxemia.

Using CPAP can help improve oxygenation by maintaining positive end-expiratory pressure in the lungs, which helps to keep the alveoli open. This promotes better gas exchange and may enhance the patient's ability to oxygenate, especially in cases such as pulmonary edema, chronic obstructive pulmonary disease (COPD), or obstructive sleep apnea, where atelectasis or airway collapse may be contributing factors. CPAP not only increases the amount of oxygen delivered but also improves ventilation-perfusion matching in the lungs.

Other options may not provide the necessary support for this specific patient scenario. For example, placing the patient on a non-rebreathing mask could further limit the ability to monitor and manage underlying issues effectively, while a partial rebreathing mask does not offer as much respiratory support as CPAP. Increasing FIO2 to 0.8 via a cool aerosol