The graphic below for a patient receiving mechanical ventilation shows which of the following conditions?
a. Leak in the circuit
b. Active inspiration
c. Active exhalation
d. Intrinsic PEEP
ANS: B
Before the delivery of a mandatory breath (constant flow, volume-controlled continuous manda-tory ventilation [VC-CMV]), patient effort reaches the trigger threshold, and a normal breath is delivered (breath on left). The second breath (right) is patient triggered, but the pressure curve (arrow) is concave because of the patient's active attempt to inhale.
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