Auto-positive end-expiratory pressure masquerading as loss of lung separation during thoracoscopy.
نویسندگان
چکیده
AUTO–positive end-expiratory pressure (auto-PEEP) is well described in patients with expiratory airflow obstruction, including those who require one-lung ventilation. Unfortunately, detecting auto-PEEP with most anesthesia ventilators is difficult. We report an unusual presentation of auto-PEEP during one-lung ventilation in which a reliable method of confirming lung separation quickly directed us to the correct diagnosis.
منابع مشابه
Hypoxemia in minimally invasive esophagectomy for squamous cell carcinoma of lower esophagus
Introduction: Minimally invasive esophage-ctomy for esophageal cancer is the surgical treatment-of-choice, and comprises both thoracoscopy and laparoscopy. The risk of hypoxemia arises during one-lung ventilation in the thoracoscopy stage, especially for patients with reduced lung function, and thus poses significant threat to the surgical outcome. This case report aims to demonstrate one possi...
متن کاملDiaphragmatic electrical activity: a new tool to assess lung hyperinflation?
447 September 2014 “ EXPIRATION and slow decrease of light together reaching minimum together ... in about 10 s and immediately cry as before. Silence and hold for about 5 s.” In the script for his late play “Breath,” Samuel Beckett conveys in sound and light his awareness of long and vital expiratory times. His personal experience with emphysema might have provided some of the inspiration. In ...
متن کاملMeasurement of air trapping, intrinsic positive end-expiratory pressure, and dynamic hyperinflation in mechanically ventilated patients.
Severe airflow obstruction is a common cause of acute respiratory failure. Dynamic hyperinflation affects tidal ventilation, increases airways resistance, and causes intrinsic positive end-expiratory pressure (auto-PEEP). Most patients with asthma and chronic obstructive pulmonary disease have dynamic hyperinflation and auto-PEEP during mechanical ventilation, which can cause hemodynamic compro...
متن کاملOn-line expiratory flow-volume curves during thoracic surgery: occurrence of auto-PEEP.
Flow-volume loops were monitored continuously in 39 patients undergoing thoracic surgery requiring one-lung ventilation. In 26 of the 39 patients (67%), auto-positive end-expiratory pressure (auto-PEEP) was seen on the flow-volume curves during both two-lung and one-lung ventilation. Eighty-seven percent of the patients whose trachea was intubated with a smaller size (35- and 37-French gauge) d...
متن کاملBrochard Intrinsic ( or auto - ) positive end - expiratory pressure during spontaneous or assisted ventilation
The mechanisms generating intrinsic or auto-positive end-expiratory pressure (PEEP) during controlled mechanical ventilation in a relaxed patient also occur during spontaneous breathing or when the patient triggers the ventilator during an assisted mode [1, 2]. These include an increased time constant for passive exhalation of the respiratory system, a short expiratory time resulting from a rel...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Anesthesiology
دوره 101 5 شماره
صفحات -
تاریخ انتشار 2004