一位診斷為急性呼吸窘迫症候群（ARDS）且已插管的病人。下列何種評估發現暗示了呼氣末正壓（PEEP）的潛在併發症？
A client is diagnosed with acute respiratory distress syndrome (ARDS) and is currently intubated. Which assessment finding indicates a potential complication of positive end-expiratory pressure (PEEP)?
- ADecrease in peak airway pressure氣道尖峰壓力降低
- BIncreased urine output尿量增加
- CSudden decrease in blood pressure✓ 正解血壓突然下降
- DImprovement in arterial oxygen saturation動脈血氧飽和度改善
呼氣末正壓（PEEP）是治療 ARDS 的重要手段，旨在增加功能餘氣量（FRC）以改善氧合。然而，PEEP 會增加胸內壓（Intrathoracic pressure），導致胸腔內大血管受壓，進而減少靜脈回流（Venous return）至心臟。心輸出量（Cardiac output）下降會直接導致血壓驟降。護理師必須在監測氧合的同時，密切注意病人的血流動力學狀態，一旦出現低血壓，應懷疑 PEEP 導致的循環抑制。
Positive end-expiratory pressure (PEEP) is an important intervention for treating ARDS, designed to increase functional residual capacity (FRC) and improve oxygenation. However, PEEP increases intrathoracic pressure, which compresses the great vessels within the thorax and reduces venous return to the heart. The resulting decrease in cardiac output directly causes a sudden drop in blood pressure. While monitoring oxygenation, the nurse must also closely monitor the client's hemodynamic status; if hypotension occurs, PEEP-induced circulatory compromise should be suspected.
美國臨床對於 ARDS 呼吸器設定（如 Low Tidal Volume ventilation 及 PEEP titration）有嚴格的 Evidence-based protocol。護理師在美國執行護理時，需更主動監測 hemodynamic trends，因為美國護理師在調整呼吸器參數方面的自主權與判斷責任通常高於台灣。