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There were multiple correct responses. The patient indeed has high resistance as shown by the large difference between peak-inspiratory pressure (PIP) and plateau pressure (Pplat). They also have significant expiratory flow limitation as suggested by the shape of the expiratory flow-time curve (methods for assessing EFL will be included in another post. Additionally, the patient has higher compliance than what would be estimated by looking at the waveforms. This is due to the fact that the patient had significant auto-PEEP. In the image below, the true driving pressure (used to calculate static compliance) is 11 cm H2O (plateau – PEEPtotal) rather than the 18 cm H2O assessed by plateau – PEEPset.
High resistance in the airways explaining the high peak pressure compared to the alveolar pressure