A VAI patient with a TT is having a trial of cuff deflation to allow for speech. The patient's voice is "weak," and he can speak only two or three words with each exhalation
The respiratory therapist could adjust which ventilator settings to improve the patient's speech?
1. Expiratory time
2. Inspiratory time
3. Volume
4. PEEP
a. 1 and 3
b. 2 and 4
c. 1 and 4
d. 2 and 3
ANS: B
When the cuff is deflated, the ventilator increases flow during exhalation to maintain the set PEEP because a leak is detected. PEEP impedes expiratory flow through the ventilator expirato-ry valve, so air flows through the larynx. By using a longer inspiratory time and PEEP, the addi-tive effect produces increased speaking time and improved speech quality.
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