A hemodynamically stable patient, receiving mechanical ventilatory support with an Fio2 of 0.4, and a PEEP of 5 cm H2O, has an MIP of 25 cm H2O and an Spo2 of 96%. What should the therapist do in this situation?
A. Eliminate the PEEP.
B. Increase this patient's ventilatory support.
C. Initiate the weaning process.
D. Continue mechanically ventilating the patient with the current settings.
?ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Generally, when a patient's underlying respiratory disease begins to stabilize and reverse, consideration for ventilator discontinuation should begin. Recently, an evidence-based task force has recommended that a patient should be considered a candidate for withdrawal if: (1) the lung injury is stable/resolving, (2) gas exchange is adequate with low Fio2 (0.4 to 0.5) and low PEEP (5 to 8 cm H2O) requirements, (3) no need for vasopressor and hemodynamically stable, and (4) capable of initiating spontaneous ventilation.
D. Incorrect response: See explanation C
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