A patient, being mechanically ventilated for airflow obstruction, has developed auto-PEEP. Which of the following physiologic and/or mechanical changes can the therapist expect this patient to experience? I. increased right ventricular filling II. respiratory muscle disadvantage III. elevated end-expiratory alveolar pressures IV. decreased respiratory muscle trigger load
A. II, III only
B. III, IV only
C. I, II, III only
D. I, II, IV only
ANS: A
A. Correct response: The development of air trapping and auto-PEEP creates several challenges regarding the mechanical ventilation of patients with airflow obstruction. These include (1) placing the ventilatory muscles at a mechanical disadvantage, (2) imposing significant breath trigger loads on the muscles of ventilation, (3) reducing right ventricular filling, and (4) increases end-expiratory alveolar pressure. Auto-PEEP does not increase baseline pressure because it is not seen on the pressure-time scalar. Auto-PEEP can be seen under end-expiratory pause conditions.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.?
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