The mode that causes the greatest reduction in cardiac output ...

[codyclark]

The mode that causes the greatest reduction in cardiac output during ventilation is which of the following?
 
  a. CPAP
  b. IMV
  c. IMV with PEEP
  d. VC-CMV with PEEP

Question 2

High tidal volumes and/or high levels of PEEP can cause which of the following?
 
  a. Improvement in pulmonary blood flow
  b. Increased right ventricular afterload
  c. Interventricular septum shifts to the right
  d. Increased myocardial perfusion

[af]

Answer to Question 1

ANS: D
VC-CMV with PEEP causes the highest mean airway pressure; this results in the greatest reduc-tion in venous return and thus cardiac output.

Answer to Question 2

ANS: B
High tidal volumes and/or high levels of PEEP result in increased resistance to blood flow through the pulmonary circulation; this increases right ventricular afterload. In addition, the right ventricle becomes overdistended, causing a decrease in RV output. Dilation of the RV can also force the interventricular septum to move to the left. Left ventricular output may also be de-creased because of the expanding lungs. This plus the decreased venous return lowers cardiac output and decreases the amount of blood perfusing the myocardium.

[codyclark]

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[af]

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