A patient is intubated due to an acute exacerbation of chronic obstructive pulmonary disease (COPD).The patient is now breathing with pressure support ventilation 5 cm H₂O and continuous positive airway pressure (CPAP)5 cm H₂O.The patient is unable to flow trigger every inspiration.Unintended positive end-expiratory pressure (auto-PEEP)is measured at 10 cm H₂O.The most appropriate action to take is which of the following?

Question

Quizplus · Accepted Answer

Patients may have trouble triggering a breath when unintended positive end-expiratory pressure (auto-PEEP)is present.When this occurs,adjusting the sensitivity may not alleviate the patient's inability to trigger the ventilator.When auto-PEEP occurs in mechanically ventilated,spontaneously breathing patients with airflow obstruction,setting extrinsic PEEP to a level equal to about 80% of the patient's auto-PEEP level may allow the ventilator to sense the patient's inspiratory efforts.Decreasing the extrinsic PEEP level will not alleviate this problem.Altering the pressure support or the flow trigger will not alleviate this problem.

A Patient Is Intubated Due to an Acute Exacerbation of Chronic