Do we have labs, an arterial blood gas and an x-ray? What is her plateau pressure and how has it been trending? How much PEEP is she on? Does the ventilator have a graphics package?
Let's find her ideal body weight and look at a lung protective ventilator strategy. If need be, we can transition to pressure controlled ventilation or possibly a hybrid that allows us a degree of control over pressures and the inspiratory flow waveform. Is the patient comfortable?