title: Use of non-partitioned ventilator tubing results in dead-space ventilation hypercarbia.
abstract: We present a case of severe postoperative hypercarbia in a patient with severe COPD. Hypercarbia and respiratory acidosis continued to increase despite maximal ventilation, bronchodilator therapy, sedation, and paralysis. Mistaken use of non-partitioned ventilator circuit was the cause of the hypercarbia. The ventilator's self-test function failed to detect the error. We changed to a partitioned-lumen circuit, with much less ventilation dead space, and the hypercarbia resolved immediately.
authors.affiliation: Department of Anesthesiology, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Bassem O
authors.initials: BO
authors.lastname: Asaad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Helwani
authors.forename: David M
authors.initials: DM
authors.lastname: Wheeler
authors.forename: Michael S
authors.initials: MS
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D004868:Equipment Failure; D006801:Humans; D006935:Hypercapnia / Q000209:etiology*; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation*; D012122:Ventilators, Mechanical / Q000009:adverse effects*