What should be increased in a 4 kg infant receiving volume control ventilation who appears tachypneic?

In a scenario where a 4 kg infant receiving volume control ventilation appears tachypneic, increasing the set tidal volume is appropriate. Tachypnea in this context may indicate that the infant is not receiving adequate ventilation, potentially leading to insufficient tidal volume for their needs.

By increasing the set tidal volume, the infant can receive a larger volume of air with each breath, which can improve oxygenation and reduce the work of breathing. This adjustment directly addresses the need for better gas exchange and helps alleviate the infant's respiratory distress.

While it may also be useful to consider other factors such as respiratory rate or adjustments in PEEP and FiO2, the immediate concern in this case is the adequacy of tidal volume provided during ventilation. It is essential to ensure that the infant is ventilating appropriately to meet their metabolic needs, and increasing tidal volume is a direct way to support that need.