Which setting should be increased in order to decrease the work of breathing for a patient on ventilatory support?

• A. PEEP
• B. Pressure support
• C. Tidal volume
• D. Respiratory quotient

Answer: (B)

Increasing pressure support is a strategy used to reduce the work of breathing for a patient on ventilatory support. Pressure support is a mode in mechanical ventilation where a preset level of pressure is provided to assist the patient's spontaneous breaths. By increasing this level of pressure support, the ventilator effectively helps to overcome any resistance in the airways and reduces the effort needed by the patient to initiate and sustain each breath.

When pressure support is elevated, it allows patients to take shallower breaths more comfortably and with less energy expenditure. This is especially beneficial for patients who may experience fatigue or respiratory distress, as it lowers the inspiratory effort required to draw air into the lungs. Consequently, the patient experiences an easier breathing pattern and improved ventilation.

Other settings may influence breathing but do not specifically target the reduction of work of breathing in the same direct manner. For instance, increasing PEEP could improve oxygenation but may increase the work of breathing in some patients by making it more difficult to initiate a breath. Adjusting tidal volume can influence ventilation but does not necessarily address the effort required to breathe. The respiratory quotient, which is a measure of gas exchange efficiency, isn't directly relevant to altering the mechanical aspects of breathing work in ventilator settings.