For patients with hypoxemia who have high airway resistance due to ET tube size, what is a critical ventilation strategy?

• A. Increasing PEEP settings
• B. Using high inspiratory pressures
• C. Incorporating pressure support
• D. Decreasing FIO2 levels

Answer: (C)

In patients with hypoxemia who experience high airway resistance, incorporating pressure support is a critical ventilation strategy. Pressure support ventilation helps overcome the increased resistance in the airways by providing additional pressure during inspiration. This assists the patient in achieving adequate tidal volumes without requiring excessive effort, which is significant in the context of high airway resistance.

By delivering a preset level of pressure, pressure support ventilation reduces the work of breathing and improves ventilation efficiency, leading to better oxygenation and carbon dioxide elimination. This is particularly important for maintaining adequate gas exchange in the face of compromised respiratory function.

Other strategies, such as increasing PEEP, using high inspiratory pressures, or decreasing FIO2 levels, are not as effective in directly addressing the issue of high airway resistance and the associated hypoxemia. PEEP might enhance oxygenation in certain situations but could potentially worsen airway resistance. High inspiratory pressures can lead to excessive ventilatory pressures that may not fit well with the patient's needs or comfort. Decreasing FIO2 levels could worsen hypoxemia rather than alleviate the situation. Thus, incorporating pressure support is the most appropriate choice in improving ventilation for these patients.