The flow, volume, and pressure scalars presented here are from a patient who is receiving mechanical ventilatory support for respiratory failure caused by obstructive airway disease. Based on these scalars, which of the following problems is the patient experiencing?

A. triggering dyssynchrony
B. rapid rise time
C. auto-PEEP
D. high Pplateau

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: The three scalars presented here depict volume controlled mechanical ventilation.

?
No patient triggering is occurring. During the breaths labeled "A" and "B," the expiratory flow does not return to the baseline before the ensuing inspiration begins. Inspiratory flow is delivered to the patient while expiratory flow from the patient takes place. This situation produces dynamic hyperinflation or auto-PEEP. The Pplateau is 30 cm H2O, which an acceptable pressure level. Keep in mind that in obstructive airway disease, overdistention of healthy lung regions may still occur despite a Pplateau of 30 cm H2O or less.
D. Incorrect response: See explanation C

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