What problem is the therapist likely to observe when a mechanically ventilated COPD patient continues to receive inspiratory flow while the patient is actively exhaling?
A. auto-triggering
B. flow starvation during inspiration
C. ineffective triggering
D. respiratory muscle unloading
?ANS: C
A. Incorrect response: Auto-triggering results from an overly sensitive triggering system.
B. Incorrect response: An inspiratory flow that does not meet the patient's inspiratory demands tends to cause flow starvation during inspiration.
C. Correct response: Dynamic hyperinflation and auto-PEEP develop when the ventilator continues to provide inspiratory flow while the patient actively exhales. Subsequently, the patient will be required to breath through any applied PEEP and trapped air, thus, causing ineffective triggering and patient-ventilator dyssynchrony.
D. Incorrect response: The situation described here would tend to cause the muscles of respiration to work hard.
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