When a therapist progressively decreases the mandatory rate when ventilating a patient with VC-SIMV, what can the therapist expect to observe as the spontaneous VT decreases and the VD/VT ratio increases?
A. an increased spontaneous respiratory rate
B. ventilation–perfusion mismatching
C. an increased shunt fraction
D. a decrease in the spontaneous ventilatory effort
?ANS: A
A. Correct response: When SIMV is used alone (i.e., without pressure support ventilation),, a decrease in the number of ventilator breaths produces a decrease in the average VT of the spontaneous breaths. At the same time, the patient's VD/VT ratio increases. To compensate for the smaller spontaneous tidal volumes and the increased VD/VT ratio, the spontaneous respiratory rate often increases.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.
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