When arterial blood gas results show a pH of 7.48 and PaCO2 of 32 torr, what should be adjusted?

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In the context of arterial blood gas (ABG) interpretation, a pH of 7.48 indicates that the blood is slightly alkalotic, meaning there is an excess of base or a deficit of acid in the blood. The PaCO2 of 32 torr suggests that there is a lower than normal level of carbon dioxide, which is typically associated with hyperventilation. The primary goal in managing such a case is to correct the respiratory alkalosis reflected by these values.

When the patient is hyperventilating, as indicated by the low PaCO2, decreasing the set IPAP (Inspiratory Positive Airway Pressure) level would be appropriate. This adjustment would help reduce the amount of air (and thus CO2) removed during each breath, allowing CO2 levels to rise back closer to normal and compensating for the alkalosis.

Therefore, adjusting down the IPAP helps to give the patient a chance to retain more CO2, leading to stabilization of blood pH towards normal values. The other options would either exacerbate the issue of alkalosis or are unrelated to the immediate concern of correcting the elevated pH and low CO2 levels.

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