If a patient shows increased PaCO2 levels, what action should be taken?

Increasing the Inspiratory Positive Airway Pressure (IPAP) setting is the appropriate action to take when a patient displays elevated levels of PaCO2, which indicates hypoventilation or inadequate ventilation. Increasing the IPAP improves the pressure support during the inspiratory phase of breathing, which can enhance tidal volume and, consequently, facilitate the removal of carbon dioxide from the bloodstream. This mechanical assistance helps to initiate a more effective respiratory effort, reducing the PaCO2 levels by promoting better gas exchange.

In contrast, decreasing the EPAP setting would reduce the baseline pressure in the airways, which is not beneficial for increasing ventilation and could lead to further increases in PaCO2. Changing to a different mode may not directly address the underlying issue of hypercapnia and could disrupt the current treatment approach. Adjusting the oxygen flow rate primarily addresses oxygenation and does not directly affect carbon dioxide elimination. Hence, increasing the IPAP provides a targeted and effective response to elevated PaCO2.