A neonate is being ventilated with PRVC. The respiratory therapist responds to a low volume alarm. After checking the patient and the ventilator, the respiratory therapist finds no discon-nects. The most appropriate action is which of the following?
a. Draw a sample for arterial blood gas eval-uation.
b. Increase the target volume.
c. Put the patient in the PC-CMV mode.
d. Recommend surfactant replacement ther-apy.
ANS: B
In the PRVC mode, if the ET tube has a leak, the level of support will be reduced; this occurs because the ventilator is sensing more volume is being delivered for a given pressure, when actu-ally the gas is escaping around the cuffless ET tube. With the alarms set properly, this problem is caught. The patient should be switched to the PC-CMV mode, in which the set pressure is not automatically altered by the ET tube leak.
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