Which of the following factors appears to be responsible for the development of necrotizing tracheobronchitis that is observed in some neonates receiving HFJV? I. high mean airway pressures II. high gas velocity III. inadequate airway humidification IV. auto-PEEP
A. I, II only
B. II, III only
C. I, III, IV only
D. I, II, III, IV
ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Adequate humidification can be difficult to achieve when high gas flows and a large minute ventilation are used. The high gas velocity of HFV (especially HFJV) also may cause direct physical airway damage. These two factors (inadequate airway humidification and high gas velocities) are thought to be responsible for the development of necrotizing tracheobronchitis observed in some neonates receiving HFJV.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.
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