A patient having an acute, severe asthma exacerbation is intubated and set up on vol-ume-controlled continuous mandatory ventilation (VC-CMV)
To ensure volume delivery at the lowest peak pressure while providing for better air distribution, which flow waveform should be used?
a. Sine
b. Constant
c. Ascending ramp
d. Descending ramp
ANS: D
In patients with high airway resistance (Raw), the descending pattern is more likely to deliver a set tidal volume (VT) at a lower pressure and provide for better distribution of air through the lung than a constant or an accelerating flow.
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