The therapist is about to initiate mechanical ventilation using heliox as the source gas. Which of the following considerations should the therapist take into account while setting the mechanical ventilator?
A. to use volume ventilation
B. to employ pressure ventilation
C. to administer continuous mandatory ventilation with the patient sedated and paralyzed
D. to avoid using any closed-loop modes of mechanical ventilation
ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Heliox administration via mechanical ventilation can be problematic. Ventilators are designed to deliver a mixture of air and O2. The different density and viscosity of helium can affect the delivered Vt and the exhaled Vt. For some ventilators, no reliable Vt is delivered with heliox. For other ventilators, a Vt higher than desired may be delivered. This problem can be circumvented partially by selecting pressure ventilation rather than volume ventilation. Unlike flow sensors, pressure sensors are not affected by a different gas composition.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.
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