Based on the arterial blood gas analysis of a patient receiving volume-controlled ventilation, what is the first recommendation?

• A. Increase pressure support to 10 cm H2O
• B. Remove deadspace
• C. Increase mandatory rate to 18
• D. Increase tidal volume to 550 mL

Answer: (C)

In situations involving arterial blood gas analysis for a patient on volume-controlled ventilation, the primary goal is often to address issues such as inadequate ventilation or oxygenation effectively. Increasing the mandatory rate is a common strategy to enhance ventilation for a patient who may be hypoventilating or exhibiting signs of respiratory acidosis, as it encourages a higher frequency of breaths per minute.

By increasing the mandatory rate to 18, you facilitate more frequent breath delivery, which can help improve overall ventilation, allowing for more carbon dioxide elimination and enhancing oxygenation. This action is particularly important if the blood gas analysis shows elevated levels of carbon dioxide or insufficient oxygen levels.

The other options involve adjustments that may not directly address the immediate concerns reflected in the blood gas analysis. Increasing pressure support or tidal volume can improve ventilation, but changing these settings might not correspond with the urgent needs based on the current analysis. Removing deadspace is also a valid consideration in certain contexts but is often more complex and not an immediate fix compared to adjusting the mandatory rate. Thus, increasing the mandatory rate appropriately responds to the scenario posed by arterial blood gas issues.