Question

Case Study 22-2 You are called to the bedside of a patient because the nurse is concerned that the ventilator's high pressure alarm has gone off. The female patient was admitted for COPD exacerbation and was intubated earlier in the day when she failed a trial of BiPAP. You review the patient's chart and note that 30 minutes earlier, the peak pressure was 45 cmH20 and the Pplateau was 25 cmH20. At the time the nurse calls you, the peak pressure

Answer 1

1. P plateau represents lung compliance, that is after the end of inspiration and next expiration there would be a pause. If any problem with the compliance, the pressure will rise.

2. after inhalation, the pressure reaches to a certain point .as the breath holds, there will be an equilibrium pressure until exhalation (release of pressure)

3.P pressure represents the airway resistance in the lungs. so, the peak pressure will rise with airway problems.

4. here the pressure alarm is going off the problem may be related to high peak pressure or high plateau pressure. The difference between peak pressure and plateau pressure is 14.71 mm Hg, If the difference between peak pressure and plateau pressure exceeds 5 mm Hg then there is high peak pressure.

60 cm H2O= 44.13 mmHg

40 cmH2O =29.42 mm Hg

the rise in peak pressure may be related to airway occlusion (issues related to airway).