skip to main content

COPD Weaning Ventilation Mode — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateIntensive Care MedicineCOPD Weaning Ventilation ModeFRCA Final

A 55-year-old man (ASA III) in ICU has an acute exacerbation of COPD requiring ventilation. He is difficult to wean. Regarding ventilatory strategy, which mode is most appropriate for weaning a COPD patient?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — High-frequency oscillatory ventilation

Pressure support ventilation (PSV) is the preferred weaning mode for COPD patients. It augments the patient's spontaneous breathing effort with a set inspiratory pressure, reducing work of breathing while maintaining patient-ventilator synchrony and respiratory muscle conditioning. Key settings in COPD: low-level PEEP (counterbalances intrinsic PEEP from air trapping, reducing the inspiratory threshold load), adequate expiratory time (I:E ratio ≥1:3), and gradual reduction of pressure support (by 2-4 cmH2O increments) as the patient strengthens. Avoid excessive mandatory rates which cause respiratory muscle atrophy.

Reference: BTS/ICS – 2016 – AECOPD ventilatory management; ICS – 2023 – Weaning guidelines