FFICM FFICM Critical Care Monitoring and Hemodynamics 2 — Questions and Answers
Question 1: Which ventilator mode delivers a set tidal volume regardless of airway resistance or compliance?
- Volume-controlled ventilation (Correct answer)
- Pressure-controlled ventilation
- Pressure support ventilation
- CPAP
Correct answer: Volume-controlled ventilation
Volume-controlled ventilation (VCV) delivers a preset tidal volume with each breath, with airway pressure varying based on lung mechanics.
Question 2: What is the recommended tidal volume per kilogram of ideal body weight in ARDS lung-protective ventilation?
- 6 mL/kg IBW (Correct answer)
- 10 mL/kg IBW
- 12 mL/kg IBW
- 4 mL/kg IBW
Correct answer: 6 mL/kg IBW
The ARDSNet trial established 6 mL/kg ideal body weight as the lung-protective tidal volume to reduce ventilator-induced lung injury.
Question 3: Which condition is a contraindication to prone positioning in mechanically ventilated ARDS patients?
- Unstable spinal fracture (Correct answer)
- Refractory hypoxemia
- PaO2/FiO2 ratio <150
- Recruitment maneuver failure
Correct answer: Unstable spinal fracture
Unstable spinal fractures are an absolute contraindication to prone positioning due to the risk of spinal cord injury during turning.
Question 4: What does intrinsic PEEP (auto-PEEP) result from in mechanically ventilated patients?
- Incomplete exhalation before the next breath (Correct answer)
- Excessive inspiratory flow rate
- Circuit disconnection
- High FiO2 delivery
Correct answer: Incomplete exhalation before the next breath
Auto-PEEP occurs when the expiratory time is insufficient for complete lung emptying, trapping air and creating inadvertent positive end-expiratory pressure.
Question 5: Which index is used to assess weaning readiness and is calculated as respiratory rate divided by tidal volume in liters?
- Rapid shallow breathing index (RSBI) (Correct answer)
- P0.1
- CROP index
- NIF
Correct answer: Rapid shallow breathing index (RSBI)
The Rapid Shallow Breathing Index (RSBI = f/VT) predicts weaning failure when >105 breaths/min/L, as validated by Yang and Tobin.
Question 6: In pressure support ventilation, which parameter does the clinician set directly?
- Inspiratory pressure above PEEP (Correct answer)
- Tidal volume
- Respiratory rate
- Inspiratory time
Correct answer: Inspiratory pressure above PEEP
During pressure support ventilation, the clinician sets the inspiratory pressure level above PEEP; tidal volume and rate are determined by patient effort and lung mechanics.
FFICM FFICM Critical Care Monitoring and Hemodynamics 2
Which ventilator mode delivers a set tidal volume regardless of airway resistance or compliance?