In managing a child on mechanical ventilation in the Assist/Control, Volume Control mode, how should the specialist increase minute ventilation?

In managing a child on mechanical ventilation in the Assist/Control, Volume Control mode, increasing the mandatory rate is the most effective way to increase minute ventilation. Minute ventilation (the total volume of gas entering and leaving the lungs per minute) is a product of both tidal volume and respiratory rate. In this mode, the ventilator delivers a set tidal volume with each breath, whether those breaths are initiated by the patient or the ventilator.

By increasing the mandatory rate, you effectively increase the number of breaths the ventilator delivers per minute. Because each of these breaths delivers a predetermined tidal volume, increasing the rate directly impacts minute ventilation. Therefore, this adjustment is essential in situations where the child may not be generating sufficient spontaneous breaths on their own, or if there is an increase in the need for ventilatory support due to changes in clinical status.

The other options, while relevant to ventilation management, do not directly increase minute ventilation in the same way. For example, increasing FiO2 provides more oxygen content but does not influence the volume of air exchanged per minute. Increasing PEEP (Positive End-Expiratory Pressure) may improve oxygenation by preventing alveolar collapse but could also reduce tidal volumes if overused, potentially leading to lower minute ventilation