Question

A 62-year-old woman is receiving ventilatory support with volume ventilation. She had abdominal surgery 10 hours ago. She has no history of smoking. Over the past few hours, the following patient information was gathered.

Time	0700	0900	1000
Volume	450 mL	450 mL	450 mL
PIP	18 cm H2O	24 cm H2O	27 cm H2O
Pplateau	13 cm H2O	12 cm H2O	14 cm H2O

1. What is the most likely cause of the increase in PIP between 0700 and 1000?

2. List some of the problems that can cause this type of increase in PIP.

3. What actions should the respiratory therapist take to determine the source of this patient's problem?

Answer 1

Answer 1: The total amount of airway pressure delivered by the ventilator to overcome resistive and elastic work is defined as peak pressure.The cause of increase in PIP can be increased airway resistance.

Answer 2:Some of the problems which can cause increased airway resistance are increased secreation, bronchospam, bitting on ventillator tubing and decreased lung compliance.

Answer 3: The first thing that the respiratory therapist should take is to

• check the connections of the ventilator tubings,
• Check if patient is bitting the tubes
• Do suction to clear excess secretions.
• Some patients may need a bigger size of the tube.
• Check the gas flow rate.
• Do an arterial blood gas analysis.