FFICM Respiratory Management and Mechanical Ventilation 3

Question 1

According to the Berlin Definition, which PaO2/FiO2 ratio (with PEEP ≥5 cmH2O) classifies ARDS as severe?

Accepted Answer

<100 mmHg

Answer

The Berlin Definition defines severe ARDS as PaO2/FiO2 <100 mmHg, moderate as 100–200 mmHg, and mild as 200–300 mmHg, all requiring PEEP ≥5 cmH2O.

Question 2

Current evidence-based guidelines recommend prone positioning in severe ARDS for a minimum duration of:

Accepted Answer

At least 12–16 hours per session

Answer

The PROSEVA trial used sessions of ≥16 hours, and guidelines recommend ≥12 hours to achieve the survival benefit observed with prone positioning.

Question 3

Non-invasive positive pressure ventilation (NIV) is most strongly indicated in COPD exacerbation when:

Accepted Answer

The patient has hypercapnic respiratory failure with arterial pH 7.25–7.35

Answer

NIV reduces intubation rates and mortality in COPD exacerbation with moderate acidosis (pH 7.25–7.35); below 7.25 or airway compromise favours intubation.

Question 4

Compared with conventional oxygen therapy, high-flow nasal oxygen (HFNO) most notably differs by:

Accepted Answer

Delivering heated humidified gas at up to 60 L/min, generating modest nasopharyngeal CPAP and reducing anatomical dead space

Answer

HFNO provides high-flow heated humidified oxygen that washes out nasopharyngeal dead space, generates 1–2 cmH2O CPAP per 10 L/min, and improves patient comfort.

Question 5

In a patient with severe status asthmaticus requiring mechanical ventilation, the preferred ventilation strategy is:

Accepted Answer

Permissive hypercapnia with low respiratory rates to allow adequate expiratory time and prevent air trapping

Answer

Bronchospasm causes severe expiratory flow limitation; low rates and long expiratory times reduce auto-PEEP and dynamic hyperinflation, and permissive hypercapnia is tolerated.

(FFICM) Final Faculty of Intensive Care Medicine Practice Test

(FFICM) Final Faculty of Intensive Care Medicine Practice Test

FFICM Respiratory Management and Mechanical Ventilation 3