A 48-year-old man on ICU is being ventilated. His ventilator shows an inspiratory:expiratory (I:E) ratio of 1:1. The normal I:E ratio during conventio...

Question

A 48-year-old man on ICU is being ventilated. His ventilator shows an inspiratory:expiratory (I:E) ratio of 1:1. The normal I:E ratio during conventional ventilation is approximately 1:2. Under what clinical circumstances might an I:E ratio of 1:1 or greater (inverse ratio ventilation) be intentionally used?

Accepted Answer

In severe ARDS, inverse ratio ventilation (IRV, I:E ≥1:1) may be used to increase mean airway pressure and improve oxygenation by prolonging the inspiratory phase, which recruits collapsed alveoli; however, evidence for mortality benefit is lacking and it requires deep sedation ± paralysis

Answer

Never - inverse ratio ventilation is always harmful

Answer

In status asthmaticus to allow longer expiration

Answer

In all ventilated patients as standard practice

Answer

Only in paediatric patients

uk-fficm MCQ (SBA): Inverse Ratio Ventilation