Cough Reflex Test (CRT) Practice

Maintaining a patient's tidal volume during noninvasive positive pressure ventilation is crucial, especially when faced with increased pulmonary compliance. When compliance increases, the lungs become more distensible, leading to the risk of delivering a larger tidal volume than intended if the pressure settings remain unchanged.

To counteract this situation, it is appropriate to decrease the inspiratory positive airway pressure (IPAP). Lowering the IPAP reduces the pressure applied during the inspiratory phase, which directly limits the volume of air delivered to the patient. By doing so, the tidal volume can be regulated more effectively, ensuring that it remains within the desired range despite the changes in lung compliance. Adjusting IPAP serves as a means to manage the relationship between pressure and volume, thereby protecting the patient from potentially harmful excessive volumes.

Consideration of the other options highlights why they are not suitable for maintaining tidal volume under these circumstances. Increasing the expiratory positive airway pressure (EPAP) would generally increase the baseline pressure during exhalation, which could inadvertently inflate the lungs more and potentially increase the tidal volume. Adjusting tidal volume upwards would also risk delivering too much volume if compliance is high. Lastly, increasing alarm sensitivity doesn’t influence the tidal volume directly; it would merely provide alerts regarding