How to improve oxygen levels after ventilator support?

Question

Hello doctor,

I am attaching the medical report of my 81-year-old grandmother. She has been hospitalized for a month. Kindly check and suggest what we can do to improve her health condition.

My grandmother underwent a subtrochanteric proximal fracture of the right femur. Following this, she was on bed rest. During this period, she developed an acute onset of breathlessness and reduced urine output. Then, she presented with hypotension and respiratory failure.

She was intubated in the casualty and started on injections of Taxim (Cefixime) and Metrogyl (Metronidazole). After 48 hours, she became drowsy and developed respiratory distress. She was again intubated, and CT thorax showed bilateral moderate pleural effusion with collapse. A diagnostic tap was suggestive of transudate and was treated with human albumin and diuretics.

Currently, she has a respiratory rate of 12 breaths per minute and is still on a ventilator. When the ventilator support is removed, the oxygen level in her blood goes down.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Based on your query, my opinion is as follows:

Need to continue on ventilator support. Any attempt to remove it should be done slowly and only when her oxygen levels remain stable without support.
Cardiac function should improve, but it would take time. Stable blood pressure is important, and medications may be required to maintain it.
Pleural effusion and edema are secondary to low albumin. Albumin correction is necessary, along with careful fluid management.
Preventive antibiotics need to be continued to avoid further infection, as she is at higher risk due to prolonged hospitalization.

At present, psychological support from family is necessary. Even simple things like talking to her, holding her hand, and being present are important. Need to avoid any further infections by maintaining proper hygiene and limiting outside exposure.

A lung condition may take time to recover from, so patience is important. Gentle chest care and regular suctioning help keep the airways clear. Nutrition support is also very important, as good protein intake helps in healing and improving strength.

Her cardiac function and protein levels should improve gradually with ongoing care. Since infections are under control, it is important to continue the current line of treatment and closely monitor her response.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.