How should the therapist manage a patient who has failed a couple spontaneous breathing trials? I. Focus on preventing VILI. II. Reestablish a nonfatiguing mode of ventilatory support. III. Ascertain the cause of weaning failure. IV. Employ volume-controlled mechanical ventilation and sedation
A. I, III only
B. I, IV only
C. I, II, III only
D. I, III, IV only
ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: First, the focus must be on the cause of ventilator dependence. Efforts toward improving the respiratory drive, cardiac function, gas exchange, or muscle fatigue must be exercised. The plan must also focus on managing the ventilator and the patient's respiratory muscle loading. The therapist must work toward preventing VILI and providing a mode of mechanical ventilation that offers nonfatiguing synchronous respiratory muscle loading.
D. Incorrect response: See explanation C
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