Question

A patient is undergoing laparoscopic abdominal surgery with deep paralysis. Which of these ventilator modes should be selected, and why?

A) Patient Regulated Volume Control—the patient may continue to make respiratory efforts and would otherwise ""fight"" against the ventilator.
B) Pressure Support—the patient may continue to make respiratory efforts and would otherwise ""fight"" against the ventilator.
C) Patient Regulated Volume Control—the patient's diaphragm is unable to contract, leaving the patient unable to assist with ventilation.
D) Pressure Support—the patient's diaphragm is unable to contract, leaving the patient unable to assist with ventilation.
E) None of the above correctly explain what would be chosen and why.

Answer 1

Controlled Mechanical Ventilation is the suitable mode for a deeply paralyzed patient, as the patient's diaphragm is unable to contract, preventing sufficient respiratory efforts. Neither Patient Regulated Volume Control nor Pressure Support is appropriate in this situation.

Step-by-step explanation:

The appropriate ventilator mode for a patient undergoing laparoscopic abdominal surgery with deep paralysis would be Controlled Mechanical Ventilation (CMV) or a similar mode where the ventilator provides full support for the patient's breathing efforts. Since the patient is experiencing deep paralysis, including paralysis of the diaphragm, voluntary and involuntary breathing efforts are significantly compromised or absent. In such a case, neither Patient Regulated Volume Control (where the patient can trigger the ventilator) nor Pressure Support (which assists with spontaneous breathing efforts) would be appropriate because the patient's ability to initiate or support the breathing is insufficient.