Which of the following is false about artificial tracheal airways and weaning?
a. There are decreases in tube inner diameter (ID) and increases in VE increase the work of breathing.
b. The added work due to artificial airways can increase ventilator dependence.
c. Artificial airways can increase the work of breathing nearly three-fold.
d. Tracheostomy tubes increase the work of breathing more than can endotracheal tubes.
ANS: D
The presence of an artificial airway may increase airway resistance nearly three-fold, although some evidence calls into question the assumption that breathing through an endotracheal tube offers a greater work of breathing than does breathing through a natural airway postextubation. In a study with 14 successfully extubated patients, at the end of a 2-hr spontaneous breathing trial, there was no difference in work of breathing before and after extubation.
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