Which of the following hemodynamic alterations will occur when a patient transitions from positive-pressure breathing to spontaneous ventilation? I. Venous return increases. II. Left ventricular afterload increases. III. Right ventricular preload decreases. IV. Cardiac output decreases
A. I, II only
B. I, II, III only
C. I, III, IV only
D. II, III, IV only
ANS: A
A. Correct response: Because a decrease in pleural pressure accompanies the transition from positive-pressure ventilation (PPV) to spontaneous ventilation (SV), and because pleural pressure directly affects the right atrial pressure, venous return increases. The drop in pleural pressure also causes left ventricular afterload to increase.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.
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