Q: All of the following strategies can be applied for ventilator management if patient develops Broncho-pleural fistula (BPF) except? 

A) Minimize the ventilator-delivered breaths.
B) Minimize the tidal volume
C) Decrease the inspiratory flow rate 
D) Decrease chest tube suction 
E) Endeavors to expedite the extubation



Answer: C

If patient develop BPF, all measures should be implied to decrease the level of positive pressure deliver via ventilator like decreasing respiratory rates, tidal volumes, PEEP and ideally to extubate the patient. Chest tube suction is another form of pressure suction from other side. 

Choice C is wrong as decreasing the inspiratory flow rate will increase the Inspiratory to Expiratory ratio (I:E) ratio and thereby chances of auto-PEEP.

Choice A and B may cause permissive hypercapnia but it should be perfectly fine.