Author Question: Which of the following statements refers to the theory associated with biotrauma as a mechanism of ... (Read 13 times)

ericka1 · **on:** Jul 16, 2018

Which of the following statements refers to the theory associated with biotrauma as a mechanism of VILI?

A. O2 radicals contribute to the disruption of the alveolar-capillary membrane.
B. Neutrophils and alveolar macrophages directly reduce the integrity of the alveolar-capillary membrane.
C. Increased inflammatory mediators in the lungs perpetuate and worsen lung injury.
D. High alveolar pressure causes the alveoli to stretch and disrupt the alveolar-capillary membrane.

Question 2

What problem is associated with using pressure-volume loops to determine potential levels of appropriate PEEP for protective lung strategy?

A. Patients need to be sedated and paralyzed.
B. Technology is unavailable to accommodate the widespread use of this strategy.
C. This protective lung strategy cannot be used in all patients receiving mechanical ventilation.
D. This strategy only works for patients who have decreased pulmonary compliance.

duy1981999 · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: The hypothesis of biotrauma as a mechanism of VILI is that the same injurious large tidal volumes cause barrier disruption and results in the release of inflammatory mediators in the lungs, thus perpetuating or worsening lung injury. The theory further proposes that these inflammatory mediators enter the systemic circulation and contribute to the development of multiple organ dysfunction syndrome (MODS).
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: A
A. Correct response: Obtaining static pressure-volume curves to determine potential levels of appropriate PEEP requires that the patients be sedated and paralyzed, and that these measurements be performed repeatedly. Therefore, the use of pressure-volume loops to limit VILI has not entered routine clinical practice.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.