The diagram show below depicts an end-expiratory valve used to generate PEEP during mechanical ventilation. Which of the following statements describes the function of this valve?
A. A decreased flow through this apparatus causes an increased PEEP.
B. An increased flow through this device produces an increased PEEP.
C. When the flow through this apparatus remains constant, the PEEP level generated fluctuates.
D. The PEEP level produced by this device is proportional to the level of flow.
?ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The device pictured in response D is an end-expiratory valve called a flow resistor used for generating PEEP. A flow resistor requires a constant flow to maintain a constant pressure. Therefore, if the flow through a flow resistor is low, the PEEP level developed will be low. Conversely, when the flow through this device is high, the level of PEEP will be high. Another type of end-expiratory valve is the threshold resistor, which maintains a steady level of PEEP regardless of the flow moving through the device.
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