Final Answer:
C) Applying 4 to 6 cm H2O PEEP. In COPD patients with auto-PEEP, applying 4 to 6 cm H2O PEEP helps counteract dynamic hyperinflation without compromising respiratory dynamics. Thus the correct option is C.
Step-by-step explanation:
In a patient with chronic obstructive pulmonary disease (COPD) experiencing auto-positive end-expiratory pressure (auto-PEEP), the most appropriate intervention is to apply positive end-expiratory pressure (PEEP). Option C, recommending the application of 4 to 6 cm H2O PEEP, is the most suitable choice. This approach helps to counteract the effects of auto-PEEP, enhance alveolar recruitment, and improve ventilation-perfusion matching without compromising the patient's respiratory dynamics.
Auto-PEEP, also known as intrinsic PEEP or dynamic hyperinflation, occurs when there is incomplete exhalation before the next breath begins, leading to an increase in end-expiratory lung volume. This phenomenon can be detrimental, as it may result in increased work of breathing, barotrauma, and compromised hemodynamics. By applying external PEEP, the alveoli are kept partially open during expiration, preventing the collapse and improving the overall lung mechanics.
The recommended range of 4 to 6 cm H2O for PEEP strikes a balance between addressing auto-PEEP and avoiding potential adverse effects. It is crucial to tailor the PEEP setting to the individual patient's needs, considering factors such as lung compliance, airway resistance, and hemodynamic status. Regular monitoring and adjustment of PEEP levels may be necessary to optimize respiratory support and ensure patient safety. Thus the correct option is C.