A 70-year-old,61-inch-tall female patient was admitted with an acute exacerbation of chronic obstructive pulmonary disease (COPD).After 12 hours of oxygen therapy,bronchodilator therapy,and intravenous corticosteroids,the patient began to show signs of clinical deterioration.Her chest X-ray revealed an enlarged heart and bilateral infiltrates.Her arterial blood gas shows acute on chronic respiratory failure.It is decided that this patient requires intubation and mechanical ventilation.The most appropriate ventilator settings for this patient include which of the following?

Question

Quizplus · Accepted Answer

The tidal volume setting for patients with chronic obstructive pulmonary disease (COPD)should be 5-8 mL/kg with a rate of 8-16 breaths/min.Positive end-expiratory pressure (PEEP)should be less than or equal to 5 cm H₂O.The ideal body weight (IBW)for this patient is 50 kg.Therefore,her tidal volume (Vᴛ)setting should be between 250 and 400 mL.Fractional inspired oxygen (FɪO₂)should be <0.50 with a PEEP of 3⁻⁵ cm H₂O.The only answer that fits these criteria is "B."

A 70-Year-Old,61-Inch-Tall Female Patient Was Admitted with an Acute Exacerbation