Identify the patient who could benefit from sigh breaths
a. Patient on pressure-controlled continuous mandatory ventilation (PC-CMV) with peak inspiratory pressure (PIP) = 38 cm H2O
b. Patient on volume-controlled continuous mandatory ventilation (VC-CMV) with a plateau pressure (Pplateau) = 36 cm H2O
c. Spontaneously breathing patient receiving continuous positive airway pressure (CPAP)
d. 70 kg ideal body weight (IBW) patient on 400 mL with Pplateau = 25 cm H2O
ANS: D
Mechanical ventilator sigh breaths are not recommended with higher tidal volumes (VTs >7 mL/kg IBW) or in the presence of plateau pressures Pplateau >30 cm H2O. Sigh breaths may be harmful to spontaneously breathing patients receiving continuous positive airway pressure (CPAP) for the treatment of hypoxemia. Therefore, only the 70 kg ideal body weight (IBW) pa-tient on 400 mL (5.7 mL/kg) with the plateau pressure of 25 cm H2O could benefit from sigh breaths.
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