Final answer:
A patient with respiratory failure on mechanical ventilation with high PEEP displaying a stroke volume variation of 12% indicates the need for a change in ventilator settings, as this suggests volume responsiveness and potential hemodynamic instability.
Step-by-step explanation:
Regarding the question on whether a change in ventilator settings may be required for a patient with respiratory failure who is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 12 cm H2O and arterial pressure-based cardiac output (APCO) monitoring, the information that indicates a potential need for this change is an elevated stroke volume variation (SVV), specifically an SVV of 12%.
Cardiac output (CO) is the volume of blood the heart pumps through the ventricles per minute. Significant fluctuations in stroke volume can impact cardiac output, which in turn affects the blood pressure and organ perfusion. Mechanical ventilation with high levels of PEEP can increase intrathoracic pressure and alter preload, the amount of blood returning to the heart, subsequently affecting stroke volume and its variation.
An increased SVV can suggest that the patient is experiencing volume responsiveness, which in the context of mechanical ventilation and high PEEP, might be an indicator of decreased preload due to high intrathoracic pressures. A stroke volume variation of 12% is generally considered above normal, indicating that the ventilator settings may need to be adjusted to optimize cardiac filling and prevent hemodynamic instability.