An 18-year-old, 5’6″, 125 lb female patient was admitted to…

An 18-year-old, 5’6″, 125 lb female patient was admitted to the hospital 2 days ago for spinal meningitis. She developed sepsis and suffered hypercapnic respiratory failure. The patient was intubated and placed on volume-controlled continuous mandatory ventilation (VC-CMV), respiratory frequency (f) 12 breaths/min, tidal volume (VT) 500 mL, positive end-expiratory pressure (PEEP) 5 cm H2O, fractional inspired oxygen (FIO2) 0.40. Twenty-four hours later, the patient’s oxygen requirements had dramatically increased and her lung compliance had dramatically dropped, while her chest X-ray showed the development of bilateral fluffy infiltrates. The most appropriate actions to take include which of the following?