What is likely to help a patient in SIMV mode with increased labor of breathing and a mandatory rate of 14/min?

• A. Use of pressure support
• B. Increase the machine flow rate
• C. Increase PEEP
• D. Switch to pressure control ventilation

Answer: (A)

Using pressure support is likely to help a patient in synchronized intermittent mandatory ventilation (SIMV) mode who is experiencing increased labor of breathing, especially with a mandatory rate set at 14 breaths per minute. The addition of pressure support can enhance the patient's spontaneous breaths by providing an extra boost of pressure during inhalation. This support can help to decrease the work of breathing, allowing for more comfortable and efficient ventilation.

In patients who are struggling to breathe, this form of assistance alleviates some of the demand placed on their respiratory muscles, thus promoting better oxygenation and ventilation. Pressure support is specifically designed to assist during the patient-initiated breaths, which can be beneficial in reducing fatigue and improving overall respiratory function.

Increasing the machine flow rate, while it may provide a faster delivery of the tidal volume, does not directly address the increased effort a patient is exerting during spontaneous breaths. Similarly, increasing PEEP could lead to further respiratory distress by decreasing the available lung volume for breathing and may not address the underlying issue effectively in this situation. Transitioning to pressure control ventilation might change the mode of ventilation, but it does not specifically target the immediate need for support during spontaneous efforts, which pressure support does effectively.