While ventilating a grossly obese ARDS patient, the therapist notices that the Pplateau has suddenly risen from 30 cm H2O to 40 cm H2O. What should the therapist do at this time?
A. Increase the pressure limit to enable a greater tidal volume delivery.
B. Add PEEP to reduce the likelihood of dynamic hyperinflation.
C. Measure the transpulmonary pressure using an esophageal monitor.
D. Continue to ventilate this patient at the current settings until the lung compliance increases.
ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: If a severely reduced chest wall compliance is present, its effects on Pplateau need to be considered empirically or else the transpulmonary pressure should be directly measured using an esophageal pressure monitor.
D. Incorrect response: See explanation C
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