Which of the following ventilator requirements for a ventilator-assisted individual demonstrates clinical stability and indicates that the patient most likely is ready for discharge home from an acute care hospital?
a. PC-CMV, f = 14 breaths/min, PIP = 30 cm H2O, PEEP = 10 cm H2O, FIO2 = 0.5
b. VC-IMV, f = 8 breaths/min, VT = 400 mL, PS = 5 cm H2O, PEEP = 5 cm H2O, FIO2 = 0.3
c. VC-CMV, f = 12 breaths/min, VT = 600 mL, PEEP = 8 cm H2O, FIO2 = 0.6
d. PC-IMV, f = 10 breaths/min, PIP = 25 cm H2O, PS = 10 cm H2O, PEEP = 10 cm H2O, FIO2 = 0.8
ANS: B
Because the second-generation home care ventilators can deliver PC-CMV and VC-CMV or IMV and PSV and PEEP, the fact that these patients require these modes does not exclude them from being considered for home ventilation. Patients are not considered for home ventilation if they require an FIO2 greater than 0.4 and higher levels of PEEP, because this demonstrates clini-cal instability.
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