What is the maximal inspiratory pressure that should be targeted ...

[cherise1989]

What is the maximal inspiratory pressure that should be targeted when using pressure-control ventilation in patients with ARDS?
 
  a. 20 to 25 cm H2O
  b. 25 to 30 cm H2O
  c. 30 to 35 cm H2O
  d. 35 to 40 cm H2O

Question 2

What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?
 
  a. Prolonged expiratory time
  b. Permissive hypercapnia
  c. Inverse ratio ventilation
  d. Intermittent mandatory ventilation

[kiamars2010]

Answer to Question 1

ANS: C
A maximal inspiratory pressure (30 to 35 cm H2O) is chosen that is likely to avert alveolar over-distention and prevent volume-associated lung injury.

Answer to Question 2

ANS: B
In patients with ARDS, it is desirable to maintain lower tidal volumes and thus avoid volutrau-ma. The goal of reducing tidal volume and controlling ventilatory rate is achieved at the expense of considerable CO2 retention in patients with ARDS. In most cases, the PaCO2 increases from 60 to 80 mm Hg and the arterial pH decreases to approximately 7.25. Subsequent metabolic compensation tends to correct the acidosis over several days. In some cases, the acidosis is more severe but appears to be well tolerated so long as tissue oxygenation is maintained. This ventila-tory strategy has been designated permissive hypercapnia.

[cherise1989]

TY

[kiamars2010]

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