An alert patient receiving ventilatory support through a demand flow intermittent mandatory ventilation system exhibits clinical signs of an increased work of breathing whenever you try to decrease the mandatory rate below 6/min
In order to aid in weaning this patient, which of the following would you recommend?
a. Apply a low level of pressure support.
b. Apply a high level of inspiratory pressure.
c. Increase the mandatory VT.
d. Decrease the mandatory VT.
ANS: A
With intermittent mandatory ventilation, the addition of pressure support can overcome the work of breathing imposed during "spontaneous" breaths because of the presence of endotracheal and tracheostomy tubes, demand-flow systems, and ventilator circuits.
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