Identify the patient who could benefit from sigh breaths. a. ...

[Kikoku]

Identify the patient who could benefit from sigh breaths.
 
  a. Patient on pressure-controlled continuous mandatory ventilation (PC-CMV) with peak inspiratory pressure (PIP) = 38 cm H2O
  b. Patient on volume-controlled continuous mandatory ventilation (VC-CMV) with a plateau pressure (Pplateau) = 36 cm H2O
  c. Spontaneously breathing patient receiving continuous positive airway pressure (CPAP)
  d. 70 kg ideal body weight (IBW) patient on 400 mL with Pplateau = 25 cm H2O

Question 2

All of the following are appropriate situations for the use of sigh or deep breaths except which?
 
  a. During chest physiotherapy
  b. During an extubation procedure
  c. During continuous positive airway pres-sure (CPAP) with spontaneous breathing
  d. Before and after endotracheal tube suc-tioning

[courtney_bruh]

Answer to Question 1

ANS: D
Mechanical ventilator sigh breaths are not recommended with higher tidal volumes (VTs >7 mL/kg IBW) or in the presence of plateau pressures Pplateau >30 cm H2O. Sigh breaths may be harmful to spontaneously breathing patients receiving continuous positive airway pressure (CPAP) for the treatment of hypoxemia. Therefore, only the 70 kg ideal body weight (IBW) pa-tient on 400 mL (5.7 mL/kg) with the plateau pressure of 25 cm H2O could benefit from sigh breaths.

Answer to Question 2

ANS: C
Sigh breaths may be harmful to spontaneously breathing patients receiving continuous positive airway pressure (CPAP) for the treatment of hypoxemia. Sigh breaths are appropriate during chest physical therapy (CPT), extubation, and before and after suctioning.