The ventilator graphics generated by mechanical ventilation with pressure-controlled continuous mandatory ventilation (PC-CMV), rate 18, peak inspiratory pressure (PIP) 25 cm H2O,
positive end-expiratory pressure (PEEP) 5 cm H2O, are shown in the scalars below. Interpretation of these scalars reveals which of the following?
a. The flow rate is set too high and should be reduced.
b. There is air trapping that could be due to a high respiratory rate.
c. The ventilator settings are appropriate and there are no problems.
d. There is a leak in the system that needs to be identified and corrected.
ANS: B
Breaths are beginning prior to the patient completely exhaling. This is shown on the flow-time scalar by the expiratory flow not having enough time to return to zero before the next breath is delivered. It is possible that this is caused by the set rate of 18 breaths/min and/or by an increased airway resistance. One can also conclude that there is unintended positive end-expiratory pres-sure (auto-PEEP) preset in this situation.
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