A patient receiving continuous mandatory ventilation in the assist-control mode develops au-to-PEEP. Which of the following changes in ventilatory patterns would you consider to minimize the effects of auto-PEEP in this patient?
1. Decreasing the rate or increasing VT
2. Using low-rate synchronized intermittent mandatory ventilation
3. Decreasing the peak inspiratory flow
4. Lowering the VT and letting the PaCO2 rise
a. 2 and 4 only
b. 3 and 4 only
c. 1, 2, and 3 only
d. 1, 2, and 4 only
ANS: D
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