What should the therapist do if a patient becomes anxious during a spontaneous breathing trial?

• A. Return to full mechanical ventilation
• B. Measure MIP
• C. Calculate the RSBI
• D. Increase the FIO2 and continue to monitor

Answer: (A)

When a patient exhibits anxiety during a spontaneous breathing trial, returning to full mechanical ventilation is the most appropriate course of action. This approach ensures the patient's safety and comfort. Anxiety in this context can indicate that the patient is struggling to maintain adequate ventilation or oxygenation on their own, possibly due to insufficient respiratory muscle strength or other underlying issues. By reverting to mechanical support, the therapist can provide the necessary breathing assistance while also allowing time for the patient to stabilize.

Measuring Maximum Inspiratory Pressure (MIP) is valuable for assessing respiratory muscle strength, but it wouldn't address the immediate anxiety and respiratory distress the patient is experiencing during the trial. Calculating the Rapid Shallow Breathing Index (RSBI) can be useful for determining readiness for extubation, but if the patient is anxious, it may not accurately reflect their readiness to continue without support. Increasing the Fraction of Inspired Oxygen (FIO2) and continuing to monitor does not address the underlying issue of anxiety and distress and could lead to further complications if the patient is not able to breathe adequately on their own.