An Unusual Pattern of Dyssynchronous Breathing due to Expiratory Flow Obstruction in the Scavenging System Caused by the Weight of Water Condensate.
Equipment failure
Expiratory flow obstruction
Heated humidifier
Patient-ventilator dyssynchrony
Rebreathing
Scavenging system
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
entrez:
1
1
2021
pubmed:
2
1
2021
medline:
2
1
2021
Statut:
ppublish
Résumé
Patient-ventilator dyssynchrony is commonly due to patient pathophysiologic factors and imprecise ventilator settings. In unusual circumstances, such dyssynchrony can also be due to faults within the equipment preventing from its normal operation during assisted mechanical ventilation. We report a patient showing an unusual pattern of dyssynchronous breathing related to a blocked scavenging system caused by the failure of its rod valve to open. Collection of water condensate inside its reservoir bag leading to a weight drag and deformation of its shape was found to be the cause. Specifically, our patient manifested as failure to trigger with the development of high positive end-expiratory pressure (PEEP) and paradoxical pressure changes during pressure support ventilation. Water condensation distal to the ventilator exhaust gas outlet may not be immediately apparent. Clinicians should remain alert with patient-ventilator dyssynchrony, especially with an unusual pattern, as it may signify equipment faults, such as expiratory gas flow obstruction within the scavenging system. Chan KM, Ng YC, So HY. An Unusual Pattern of Dyssynchronous Breathing due to Expiratory Flow Obstruction in the Scavenging System Caused by the Weight of Water Condensate. Indian J Crit Care Med 2020;24(11):1128-1131.
Sections du résumé
BACKGROUND
BACKGROUND
Patient-ventilator dyssynchrony is commonly due to patient pathophysiologic factors and imprecise ventilator settings. In unusual circumstances, such dyssynchrony can also be due to faults within the equipment preventing from its normal operation during assisted mechanical ventilation.
CASE DESCRIPTION
METHODS
We report a patient showing an unusual pattern of dyssynchronous breathing related to a blocked scavenging system caused by the failure of its rod valve to open. Collection of water condensate inside its reservoir bag leading to a weight drag and deformation of its shape was found to be the cause. Specifically, our patient manifested as failure to trigger with the development of high positive end-expiratory pressure (PEEP) and paradoxical pressure changes during pressure support ventilation.
CONCLUSION
CONCLUSIONS
Water condensation distal to the ventilator exhaust gas outlet may not be immediately apparent. Clinicians should remain alert with patient-ventilator dyssynchrony, especially with an unusual pattern, as it may signify equipment faults, such as expiratory gas flow obstruction within the scavenging system.
HOW TO CITE THIS ARTICLE
UNASSIGNED
Chan KM, Ng YC, So HY. An Unusual Pattern of Dyssynchronous Breathing due to Expiratory Flow Obstruction in the Scavenging System Caused by the Weight of Water Condensate. Indian J Crit Care Med 2020;24(11):1128-1131.
Identifiants
pubmed: 33384522
doi: 10.5005/jp-journals-10071-23666
pmc: PMC7751046
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1128-1131Informations de copyright
Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.
Déclaration de conflit d'intérêts
Source of support: Nil Conflict of interest: None
Références
Respirology. 2003 Nov;8 Suppl:S31-5
pubmed: 15018131
Anaesthesist. 1993 Jul;42(7):470-2
pubmed: 8363032