A 65-year-old female with a history of severe COPD and coron…

A 65-year-old female with a history of severe COPD and coronary artery disease is intubated for severe acute respiratory distress syndrome (ARDS) in the setting of pneumonia. Despite ventilation with 6 mL/kg tidal volumes and neuromuscular blockade, PaO2:FiO2 remains 85 on FiO2 100%. PEEP is increased from 5 to 10 cm H2O, and mean arterial pressure subsequently decreases from 65 to 45. In what setting is increased PEEP least likely to improve oxygenation and hemodynamics?

An intubated patient is receiving enteral nutrition. Today s…

An intubated patient is receiving enteral nutrition. Today she has a new onset fever, leukocytosis, and increased sputum production. Chest x-ray demonstrates right lower lobe (RLL) infiltrate. Which of the following interventions is most beneficial to decrease the incidence of this complication?