Removing a patient from a ventilator to ventilate manually can lead to which of the following? 1. Barotrauma 2. Lung derecruitment 3. Increased airway resistance 4. Ventilator-acquired pneumonia

a. 1, 2, and 3
b. 1, 2, and 4
c. 2, 3, and 4
d. 3 and 4

ANS: B
Removing a patient from the ventilator for manual ventilation can inadvertently cause barotrauma by using excessive pressure during ventilation (>40 cm H2O). Disconnecting a patient who is be-ing ventilated with a high level of PEEP (15-25 cm H2O) can cause derecruitment of the lung. Disconnection of the ventilator can cause contamination of the patient's airway, increasing the patient's risk of developing ventilator-associated pneumonia.