How to treat this patient - ventilator asynchrony?

Last update: Wednesday, 03 Nov 2021 at 22:13

A 77 year-old woman, requiring intubation and mechanical ventilation (Servo S - Maquet) was on VCV mode with "ramp wave" format flow. Sensitivity: 2l/min.

Diagnosis: Septic shock, but stable arterial pressure.

VT was programmed to 6ml/kg: 300ml


Img 2296

Img 2297


Sedated: RASS score: -4, no signs of pain.

She was using abdominal muscles ++/4+

What would you do about the patient-ventilator asynchrony?

a) Deeply sedate the patient
b) Increase VT and inspiratory time 
c) Switch the flow profile to square wave format
d) Switch the mode to PCV maintaining the same VT