Which of the following can increase the physiological dead space in apneic patients receiving volume control ventilation?
a. I:E ratio >1:1
b. A slow flow rate
c. Adding an inflation hold
d. Inspiratory time <0.5 second
ANS: D
In an apneic patient receiving volume control ventilation, an inspiratory time that is too short (i.e., <0.5 second) may result in an increase in physiological dead space. Large I:E ratios and addition of an inflation hold increase the mean airway pressure. A slow flow rate can inverse the I:E ratio and also cause an increase in mean airway pressure.
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