A 10-year-old boy with a complex medical history including history of trisomy 21, intractable…

A 10-year-old boy with a complex medical history including
history of trisomy 21, intractable infantile spasms, seizure disorder, and
developmental delay (nonverbal), is admitted with increased difficulty
breathing. His temperature on admission is 101°F, and a chest x-ray shows a
left lower lobe infiltrate consistent with pneumonia. His home regimen includes
nocturnal NIV via nasal mask with an inspiratory pressure of 8 cm H2O,
3 cm PEEP, and 2 L/min of O2 added to the breathing circuit. On
admission, the patient complains of shortness of breath. His respiratory rate
is 40 breaths/min, and SpO2 is 88% on a nonrebreathing mask. What
should the RT suggest?

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