What is the primary concern when adjusting tidal volume in a patient with decreased lung compliance?

• A. Rapid desaturation
• B. Risk of barotrauma
• C. Increased comfort
• D. Reduced respiratory rate

Answer: (B)

The primary concern when adjusting tidal volume in a patient with decreased lung compliance is the risk of barotrauma. In patients with decreased lung compliance, the lung tissue is stiffer and less able to expand with each breath. When a higher tidal volume is set in this scenario, there is an increased pressure required to deliver that volume, which can lead to over-distention of the alveoli. This over-distention increases the risk of barotrauma, where the high pressures can cause lung tissue damage and potentially lead to the rupture of alveoli.

Barotrauma is particularly concerning because it can result in pneumothorax or other pulmonary complications, which can significantly worsen the patient's condition. Therefore, careful consideration must be given to tidal volume adjustments to avoid exceeding safe pressure limits in patients with decreased lung compliance, prioritizing lung protection while ensuring adequate ventilation.