To lower autoPEEP in a mechanically ventilated patient, which should the respiratory therapist increase?

• A. Mandatory rate
• B. Pressure support
• C. PEEP
• D. Flow rate

Answer: (D)

To lower autoPEEP in a mechanically ventilated patient, increasing the flow rate is beneficial because it can help reduce the expiratory time needed for the patient to fully exhale. AutoPEEP, or intrinsic PEEP, occurs when there is insufficient time for the lungs to completely exhale the previous breath before the next ventilatory cycle begins. By increasing the flow rate during inhalation, you can shorten the inspiratory time and subsequently allow more time for complete exhalation between breaths. This helps to minimize the amount of trapped air in the lungs, effectively lowering autoPEEP.

In contrast, adjusting parameters such as the mandatory rate, pressure support, or PEEP itself may not directly address the underlying issue of insufficient expiration time and can sometimes exacerbate the situation, leading to higher levels of autoPEEP. Therefore, increasing the flow rate focuses on optimizing the ventilatory cycle to facilitate better gas exchange and reduce residual volume in the lungs.