You are called to the NICU to perform an anesthetic on a 3.5 kg neonate with congenital diaphragmatic hernia. The patient is intubated with conventional mechanical ventilation. The most recent arterial blood gas reveals a pH 7.38, PaCO2 45 mmHg, PaO2 89 mmHg, HCO3 29 mEq/L, SaO2 of 97% on an FiO2 of 0.6. Peak airway pressures are 32 cmH2O with 5 cmH2O PEEP. Expiratory tidal volume is 45 ml. Which of the following is the MOST appropriate ventilatory management for this patient?
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