Anaes Cases · Breathing systems & circuits
The breathing-system failure during anaesthesia
The breathing-system failure long case — the differential (the disconnection, the obstruction, the ventilator failure, the circuit kink), the immediate management (the switch to the manual bag, the check the connections), and the prevention.
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ANZCAFRCAABAEDAIC
Prompt
During a general anaesthetic, the capnograph trace suddenly falls to zero and the airway pressure rises. The ventilator bellows is not moving. Discuss the differential and the management.
Presentation
During a general anaesthetic under controlled ventilation (the circle system, the ventilator at 500 mL tidal volume, 12 per minute), the capnograph trace suddenly falls to zero, the airway pressure rises from 20 to 45 cmH2O, and the ventilator bellows does not move. The oxygen saturation is 96 per cent and falling.
[3]References2ShowHide
- [3]AAGBI. Checking anaesthetic equipment 2012. Anaesthesia, 2012.PMID 22563957
- [22563958]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.