Author Question: Which of the following ventilator requirements for a ventilator-assisted individual demonstrates ... (Read 74 times)

mwit1967 · **on:** Jul 16, 2018

Which of the following ventilator requirements for a ventilator-assisted individual demonstrates clinical stability and indicates that the patient most likely is ready for discharge home from an acute care hospital?

a. PC-CMV, f = 14 breaths/min, PIP = 30 cm H2O, PEEP = 10 cm H2O, FIO2 = 0.5
b. VC-IMV, f = 8 breaths/min, VT = 400 mL, PS = 5 cm H2O, PEEP = 5 cm H2O, FIO2 = 0.3
c. VC-CMV, f = 12 breaths/min, VT = 600 mL, PEEP = 8 cm H2O, FIO2 = 0.6
d. PC-IMV, f = 10 breaths/min, PIP = 25 cm H2O, PS = 10 cm H2O, PEEP = 10 cm H2O, FIO2 = 0.8

Question 2

A patient with muscular dystrophy currently receiving ventilatory support with VC-IMV is being prepared for discharge home.

The case manager asks the respiratory therapist to recommend a ventilator that will meet the pa-tient's needs with the least complexity and at the lowest cost. The respiratory therapist should recommend which of the following ventilators?
a. PLV 102
b. LP-6 Plus
c. LTV 1000
d. Lifecare PLV 100

paavo · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: B
Because the second-generation home care ventilators can deliver PC-CMV and VC-CMV or IMV and PSV and PEEP, the fact that these patients require these modes does not exclude them from being considered for home ventilation. Patients are not considered for home ventilation if they require an FIO2 greater than 0.4 and higher levels of PEEP, because this demonstrates clini-cal instability.

Answer to Question 2

ANS: C
The LTV 1000 is the most appropriate choice, because SIMV is incorporated into the ventilator, and the associated WOB is lower than that of the first-generation ventilators (PLV 102, LP-6 Plus, and Lifecare PLV 100). This is important because this patient has a neuromuscular disease and may not be able to endure an increased WOB. Also, because the first-generation ventilators listed do not have internal IMV capabilities, an external H-valve assembly would have to be at-tached. This means additional equipment with increased complexity and possibly a higher cost compared with the second-generation ventilator (LTV 1000).