The therapist, working in an LTAC, is planning to wean a PMV patient with combined SIMV and PS. What should the therapist do in this situation?
A. The patient should be sedated, paralyzed, and placed on control mechanical ventilation before initiating weaning is attempted.
B. The combination of SIMV and pressure support ventilation is not recommended for PMV patients.
C. The therapist should proceed with the planned method of weaning.
D. Liberation from ventilatory support for this patient should employ VC-SIMV with CPAP.
ANS: B
A. Incorrect response: See explanation B.
B. Correct response: The combination of SIMV and PS is not recommended for PMV patients because of the unnatural combination of resultant tidal volumes and flow patterns for patients who are presumably not significantly sedated. This mode has previously been discredited as beneficial to the weaning process in large clinical trials. No clinical evidence supports the use of any particular ventilation mode over another with regard to speed and overall success with which liberation from full ventilatory support can be achieved.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.
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