A 67-year-old woman is intubated and mechanically ventilated through a size 6.5 cuffed endotracheal tube after a thoraco-abdominal aneurysm repair（胸腹动脉瘤修复术）. During the course of approximately（大约） 20 minutes, her oxygen saturation as measured by pulse oximetry begins to decrease from 97% to 91%, and her endtidal carbon dioxide increases from 36 mm Hg to 52 mm Hg. A flow-volume loop displayed on the ventilator is shown below.
Which of the following is the most appropriate next step in management?
A. Decrease the tidal volume delivered by the ventilator.
B. Administer inhaled bronchodilators.
C. Suction the endotracheal tube.
D. Reintubate the patient.
E. Check whether the endotracheal tube balloon is inflated（充气）.
答案解析：
流量回路显示呼吸机回路泄漏。吸气量大于呼出量。这可能位于回路的任何水平，但破裂的球囊通常会导致泄漏。在回路泄漏的情况下，减少潮气量将减少分钟通气量并增加呼气末二氧化碳，并可能通过允许肺泡萎陷而恶化氧合。不适合使用吸入性支气管扩张剂，因为没有急性阻塞性肺病的证据。由于没有胸内阻塞的证据，因此气管插管吸引不太可能有效。可能需要对患者重新插管，但这不是下一步，因为套囊可能需要简单的空气再注入。
正确答案：E
补充内容：几种呼吸机相关常见的问题波形
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