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A 60 kg patient is admitted to a general medical patient unit with myasthenia gravis. BS are clear. VS are f-18 b/min, HR 90 bpm, BP 122/83 mmHg. The patient’s ABG’s on RA are 7.39/41/89/24/97%. The patient is alert and complains of difficulty swallowing and moving his shoulders and arms. The physician orders Q4 NIF and FVC. During the next 24 hours, the vital signs and ABG’s remain unchanged. The NIF has dropped from an initial value of -60 cmH20 to -19 cmH20. The FVC has dropped from 3.0L to 0.75 L. The patient appears to have greater accessory muscle usage. What is the primary indication that this patient may require ventilatory support?

Compared to a pressure controlled strategy, what ability is the primary advantage of volume-controlled ventilatory support?

A patient is being ventilated with VC-CMV mode. if the ventilator rate is decreased, which of the following should be anticipated in the absence of patient triggering? Increase in patient’s PaC02 Unchanged minute ventilation Decrease in alveolar ventilation Increase in delivered tidal volume

What goal(s) does the practitioner hope to achieve when selecting initial ventilator support settings? Optimize oxygenation Optimize ventilation Maintain acid-base balance Avoid harmful side effects

Select the most likely effect of mechanical ventilation on the following physiologic parameter: Shunting

Select the most likely effect of mechanical ventilation on the following physiologic parameter: Mean Airway Pressure

Prolonged alveolar over-distention from mechanical ventilation leads to the release of inflammatory mediators from the lungs that can cause failure of other organs of the body. This response has been termed _______________.

Select the most likely effect of mechanical ventilation on the following physiologic parameter: Urinary Output

A patient is admitted to the ER after taking a drug overdose. The patient is obtunded and no spontaneous breathing is noted. The patient is being ventilated with a resuscitation bag. The patient’s ABG’s as 7.38/44/295/24/99%. What is the primary indication present that mechanical ventilation is indicated in this patient?

More recent evidence demonstrates that the repeated opening and closing of the lung units generates shear stress, with direct tissue injury at the alveolar and pulmonary capillary level as well as the loss of surfactant from these unstable lung units. This injury is now termed______________.