Critical care: ventilation in severe asthma: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: ventilation in severe asthma

Sample item

A ventilated patient with severe asthma has high peak pressures and breath stacking. Which ventilator strategy is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Low respiratory rate, long expiratory time and permissive hypercapnia

Bronchospasm causes air trapping and auto-PEEP. A low rate, small tidal volume and long expiratory time allow complete exhalation, and moderate hypercapnia is accepted to avoid barotrauma and hypotension. High PEEP worsens hyperinflation.

Option by option

  • A. High rate with short expiratory time

    Short expiratory time worsens stacking.

  • B. Low respiratory rate, long expiratory time and permissive hypercapnia (correct)

    Correct. This strategy reduces air trapping.

  • C. High PEEP of 15 cmH2O

    High PEEP adds to hyperinflation in asthma.

  • D. Large tidal volume of 12 mL/kg

    Large volumes increase hyperinflation and barotrauma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Low respiratory rate, long expiratory time and permissive hypercapnia. Bronchospasm causes air trapping and auto-PEEP.

Why is "High rate with short expiratory time" not the answer?

Short expiratory time worsens stacking.

Why is "High PEEP of 15 cmH2O" not the answer?

High PEEP adds to hyperinflation in asthma.

Why is "Large tidal volume of 12 mL/kg" not the answer?

Large volumes increase hyperinflation and barotrauma.

What concept does this question test?

It tests Critical care: ventilation in severe asthma in Anaesthesia. A low rate, small tidal volume and long expiratory time allow complete exhalation, and moderate hypercapnia is accepted to avoid barotrauma and hypotension. High PEEP worsens hyperinflation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: ventilation in severe asthma?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.