An intubated patient with chronic obstructive pulmonary disease (COPD)is breathing on pressure 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 synchronized and no change should be made.
B) The inspiratory flow rate should be increased 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 increased to match the peak pressure.

Question

An intubated patient with chronic obstructive pulmonary disease (COPD) is breathing on pressure 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 synchronized and no change should be made. 
B) The inspiratory flow rate should be increased 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 increased to match the peak pressure.

Quizplus · Accepted Answer

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.

An Intubated Patient with Chronic Obstructive Pulmonary Disease (COPD)is Breathing