Based on the data obtained from various studies conducted to ...

[09madisonrousseau09]

Based on the data obtained from various studies conducted to determine the effect of lung protective strategies to minimize the development of VILI in patients with ALI and ARDS, which of the following conclusions is appropriate?
 
  A. These patients must be ventilated with tidal volumes ranging between 10-12 ml/kg, and Pplateau of around 30 cm H2O.
  B. ALI and ARDS patients must be ventilated with tidal volumes around 6 ml/kg, and high level of PEEP.
  C Such patients must be ventilated with around 6 ml/kg and a Pplateau near 30 cm H2O.
  D. These patients must be ventilated with tidal volumes ranging between 10-12 ml/kg and low levels of PEEP.

Question 2

The presence of systemic and pulmonary inflammatory mediators from mechanical lung injury further contributing to the development of VILI and MODS is termed __________.
 
  A. barotrauma
  B. biotrauma
  C. atelectrauma
  D. volutrauma

[fauacakatahaias]

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Low tidal volumes are the standard of care for patients with ALI or ARDS. Tidal volumes must be at or near 6 ml/kg predicted body weight. The Pplateau should be maintained at or near 30 cm H2O. The tidal volume should be lowered to a minimum of 4 ml/kg to try to achieve a plateau pressure of 30 cm H2O or less.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: B
A. Incorrect response: Barotrauma is defined as the presence of air in the pleural space from pneumothoraces, pneumomediastinum, and pulmonary interstitial emphysema.
B. Correct response: Biotrauma develops with increases in pulmonary and systemic inflammatory mediators from mechanical lung further contributing to the development of ventilator-induced lung injury (VILI) and multiple organ dysfunction syndrome (MODS).
C. Incorrect response: Atelectrauma is lung injury resulting from mechanical stresses associated with repetitive alveolar collapse and reopening.
D. Incorrect response: Volutrauma is lung injury resulting from mechanical stretch, which leads to alveolar-capillary barrier disruption, and increases in endothelial and epithelial permeability.