The therapist is attempting to wean a mechanically ventilated COPD patient. Which of the following positions would likely facilitate this patient's weaning process?

A. lateral decubitus
B. supine
C. semirecumbent
D. prone

?ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: During an acute crisis, COPD and asthma patients tend to avoid lying supine. In one study of patients having acute asthmatic episodes, no asthmatic having a peak flow of less than 150 L/min chose to be recumbent. Reasons for this choice include the increase in airway resistance while assuming the supine position, and recruitment and optimization of accessory muscles of inspiration and expiration in the upright position.
In the absence of data for mechanically ventilated COPD patients, therapists extrapolate what is known about nonventilated patients with airflow obstruction to ventilated COPD patients. Consequently, the recommendation is to place actively weaning COPD patients in a semirecumbent (upright) position.
D. Incorrect response: See explanation C.