title: Intraoperative Autotriggered Pressure Support Ventilation Resistant to Increased Flow Trigger Threshold.
abstract: Oscillations from cardiac pulsations are normally transmitted to mediastinal structures without any consequence. Autotriggering (AT) of mechanical ventilation occurs when an inspiratory trigger, typically negative inspiratory flow in anesthesia ventilators, is met in the absence of patient effort. AT can lead to respiratory alkalosis, opioid overdose, prolonged mechanical ventilation, and lung hyperinflation. This entity has been reported in both critical care and operating room environments. Increasing the flow trigger usually resolves AT in all cases. We report a case of AT that failed to respond to increasing the flow trigger threshold to its maximal value on the GE Datex-Ohmeda Avance S5® anesthesia station.
authors.affiliation: From the Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami, Miami, Florida.
authors.forename: Julio
authors.initials: J
authors.lastname: Benitez Lopez
authors.forename: Sripad P
authors.initials: SP
authors.lastname: Rao
authors.forename: Richard R
authors.initials: RR
authors.lastname: McNeer
authors.forename: Roman
authors.initials: R
authors.lastname: Dudaryk
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D011175:Positive-Pressure Respiration / Q000379:methods*; D012123:Pulmonary Ventilation / Q000502:physiology*; D012122:Ventilators, Mechanical