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

Question 22

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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?


A) Volume-controlled continuous mandatory ventilation (VC-CMV) rate 15,VT 200 mL,FIO2 100%,positive-end-expiratory pressure (PEEP) 5 cm H2O
B) VC-CMV rate 12,VT 400 mL,FIO2 40%,PEEP 3 cm H2O
C) Pressure-controlled synchronized intermittent mandatory ventilation (PC-SIMV) rate 10,peak inspiratory pressure (PIP) 30 cm H2O,FIO2 60%,PEEP 3cm H2O
D) PC-SIMV rate 12,PIP 35 cm H2O,FIO2 30%,PEEP 8 cm H2O

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