A patient weighing 75 kg is receiving mechanical ventilation after barbiturate ingestion. What should the therapist recommend?

• A. Decrease the rate to 2
• B. Switch to CPAP
• C. Continue mechanical ventilatory support
• D. Remove from mechanical ventilation

Answer: (C)

In the context of a patient weighing 75 kg who is on mechanical ventilation following barbiturate ingestion, continuing mechanical ventilatory support is the most appropriate recommendation. Barbiturate ingestion can significantly depress the central nervous system, leading to respiratory depression or failure. In such cases, the patient's ability to maintain adequate ventilation and oxygenation is compromised. Therefore, it is crucial to provide ongoing mechanical support to ensure that the patient is both ventilated properly and their oxygen levels are maintained within a safe range.

Removing the patient from mechanical ventilation or switching to modes like CPAP (Continuous Positive Airway Pressure) might not be safe, as the patient could struggle to breathe adequately on their own due to the sedative effects of barbiturates. Decreasing the rate of mechanical ventilation could further exacerbate respiratory insufficiency, putting the patient at greater risk. Hence, maintaining mechanical ventilatory support is essential in this scenario to facilitate recovery while safeguarding the patient’s airway and breathing.