26.1You are about to transfer a ventilated 34-week male infant with respiratory distress syndrome (RDS) by aeroplane to a neonatal intensive care unit. He has been given one dose of surfactant and is currently ventilated on SIMV with a back-up rate of 40, pressures 22/6, and Fio2 25%. His oxygen saturations on pulse oximetry are 95%. His Paco2 prior to departure is 42 mmHg (5.6 kPa). The aeroplane has a pressurized cabin (equivalent to 5000 feet or 1500 m). As the aircraft climbs to 20 000 feet (6000 m) you notice his oxygen saturations slowly drop into the mid 80s. Which one of the following is the most appropriate next step?