[Intrinsic PEEP as a ventilation complication after pneumonectomy].
We report the case of a female patient who developed a clinical picture characterized by hemodynamic deterioration, bradycardia and asystole due to pulmonary hyperinsufflation (documented by X-ray examination) during the immediate postoperative phase of a right pneumonectomy. Occlusion of the respiratory limb of the respirator was followed by a positive pressure at the end of the respiration (PEEP) suggesting the presence of an intrinsic PEEP independent of the respirator. Application of a PEEP to the respirator induced a radiologic improvement. The mechanisms by which an intrinsic PEEP may develop are discussed.
Pintanel
T
T
Servicio de Anestesiología, Hospital Germans Trias i Pujol, Badalona, Barcelona.
Klamburg
J
J
Torrabadella
P
P
Font
M
M
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001919:Bradycardia / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000503:physiopathology*; D011654:Pulmonary Edema / Q000209:etiology / Q000503:physiopathology; D012123:Pulmonary Ventilation; D012121:Respiration, Artificial / Q000009:adverse effects*
PEEP intrínseca como complicación ventilatoria en el postoperatorio de neumectomía.