The values below pertain to a patient who is being mechanically ventilated with a measured ex-haled tidal volume (VT) of 700 mL
Time Peak Inspiratory Pressure (cm H2O) Plateau Pressure (cm H2O)
0800 35 30
1000 39 34
1100 45 39
1130 50 44
Analysis of this data points to which of the following conclusions?
a. Airway resistance is increasing.
b. Airway resistance is decreasing.
c. Lung compliance is increasing.
d. Lung compliance is decreasing.
ANS: D
To evaluate this information the transairway pressure (PTA) is calculated for the different times: 0800 PTA = 5 cm H2O, 1000 PTA = 5 cm H2O, 1100 PTA = 6 cm H2O, and 1130 PTA = 6 cm H2O. This data shows that there is no significant increase or decrease in this patient's airway resistance. Analysis of the patient's plateau pressure (Pplateau) reveals an increase of 15 cm H2O over the three and a half hour time period. This is directly related to a decrease in lung compliance. Calculation of the lung compliance (CS = VT/(Pplateau – EEP) at each time interval reveals a steady decrease from 20 mL/cm H2O to 14 mL/cm H2O.
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