With a patient on volume-controlled ventilation post-abdominal surgery, what adjustment should be made given the provided arterial blood gas results?

• A. Switch to assist/control mode
• B. Discontinue PEEP
• C. Decrease mandatory rate
• D. Decrease FIO2 to 0.35

Answer: (B)

In the context of a patient on volume-controlled ventilation who is post-abdominal surgery, discontinuing PEEP (Positive End-Expiratory Pressure) may be the necessary adjustment to make based on the arterial blood gas results. PEEP is used to keep the alveoli open during expiration, improving oxygenation by increasing functional residual capacity. However, excessive PEEP can lead to decreased cardiac output, increased intra-abdominal pressure, and reduced compliance, which may negatively impact the patient's respiratory status, particularly after abdominal surgery.

If the arterial blood gas results show signs of overventilation or if oxygenation is adequate, discontinuing PEEP could alleviate potential complications by improving hemodynamics and allowing for better patient comfort. Adjusting PEEP can also help to lower potential airway pressure and reduce work of breathing during ventilation, which is especially important in patients recovering from surgical procedures.

Adjusting the other parameters like switching to assist/control mode, decreasing the mandatory rate, or changing the FIO2 might not specifically address the issues indicated by the ABG results as effectively as managing PEEP would in this scenario. Each of those options could be appropriate in various situations, but focusing on PEEP as the adjustment aligns more closely with optimizing breathing mechanics and improving patient outcomes in