In mechanical ventilation, how can airway resistance be reduced?

Reducing airway resistance is essential in mechanical ventilation to enhance effective gas exchange and improve patient outcomes. Selecting a larger diameter endotracheal tube is the most effective method because it directly decreases resistance in the airway. A wider tube allows air to flow more freely, reducing the force required to move air in and out of the lungs. This is particularly important in patients with obstructive airway diseases, where narrow airways can significantly increase resistance.

When airway resistance is lowered, it helps in minimizing the work of breathing, thus making ventilation more efficient and comfortable for the patient. This approach also helps to avoid complications such as ventilator-induced lung injury, which can arise from increased pressures needed to deliver the same tidal volume through narrower tubes.

Other strategies listed, such as decreasing tidal volume or increasing respiratory rate, may not effectively address the underlying issue of increased resistance in the airway. Using positive end-expiratory pressure (PEEP) can improve oxygenation and recruitment of collapsed alveoli but does not directly affect airway resistance.