An intubated patient with chronic obstructive pulmonary disease (COPD) is breathing on pres-sure support ventilation (PSV) 13 cm H2O with positive end-expiratory pressure (PEEP) 5 cm H2O and a flow cycle setting of 25%
The pressure-time scalar shown in the figure is evaluated by the respiratory therapist. What action should the respiratory therapist take at this time?
a. The patient and ventilator are synchro-nized and no change should be made.
b. The inspiratory flow rate should be in-creased to match the patient's needs.
c. The flow cycle setting should be increased to allow more time for exhalation.
d. The pressure support setting should be in-creased to match the peak pressure.
ANS: C
The slight rise at the end of inspiration on the pressure-time scalar in the figure shows that the patient is actively exhaling before the flow-cycle criterion is being met. This problem can be avoided by using a higher flow-cycle criterion that will end inspiration sooner and allow for longer expiratory time to decrease air trapping.
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