What are the advantages of the minimal occlusion volume technique for establishing an ETT cuff seal compared with the minimal leak technique? The minimal occlusion volume technique: I. lowers the risk of silent aspiration. II. provides the lower cuff pressure. III. reduces the likelihood of nuisance ventilator alarms. IV. facilitates respiratory monitoring

A. I, II only
B. III, IV only
C. I, II, III only
D. I, III, IV only

?ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: Generally, the minimal leak technique affords lower cuff pressures than the minimal occlusion volume technique.
C. Incorrect response: See explanation D.
D. Correct response: Silent aspiration is the drainage into the lungs of oropharyngeal secretions from around the cuff of an ETT. Aspiration of oropharyngeal secretions have been demonstrated to be more prevalent at cuff pressures less than 20 mm Hg. Aspiration of oropharyngeal secretions is implicated in the development of ventilator-associated pneumonia.
The advantages of the minimal occlusion volume techniques include:
a. a) helps prevent aspiration of oropharyngeal secretions
b. b) facilitates mechanical ventilation
c. c) improves monitoring of respiratory mechanics
reduces the likelihood of nuisance ventilator alarms?