An orally intubated patient is receiving PC-CMV. The therapist suddenly notices that the patient's exhaled tidal volume has fallen significantly. Which of the following occurrences is the likely cause of this loss of volume?
A. The cuff on the endotracheal tube is overinflated.
B. The patient's static compliance has increased.
C. An oversized endotracheal tube has been used.
D. The endotracheal tube has migrated into the right mainstem bronchus.
?ANS: D
A. Incorrect response: An overinflated endotracheal tube cuff will not affect the patient's tidal volume.
B. Incorrect response: If static compliance increases, tidal volume will increase in PC-CMV. Tidal volume will decrease when Raw increases in PC-CMV.
C. Incorrect response: Using an oversized endotracheal tube will not cause the patient's tidal volume to drop suddenly.
D. Correct response: Commonly, distal migration of the endotracheal tube is detected by an increase in airway resistance during volume control ventilation, and a decrease in the tidal volume during pressure control ventilation.
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