A patient switched from pressure-controlled continuous mandatory ventilation (CMV)
with positive end expiratory pressure (PEEP) to pressure-controlled inverse ratio ventilation (PC-IRV) shows a good improvement in PaO2 but a decrease in tissue oxygenation. Which of the following best explains this observation?
a. High mean pressures caused by PC-IRV decreased pulmonary blood flow.
b. Intrinsic PEEP caused by PC-IRV result-ed in increased alveolar recruitment.
c. High mean pressures caused by PC-IRV decreased cardiac output.
d. Intrinsic PEEP caused by PC-IRV com-pressed the pulmonary capillaries.
ANS: C
Although some studies have shown improvement in oxygenation with PC-IRV versus CMV with PEEP, others have shown concurrent decreases in cardiac output.
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