Anaes Cases · Anaesthetic ventilators
Rising peak airway pressure mid-case
The short case — the rising peak airway pressure in the volume control. The systematic differential (the circuit, the airway, the lung, the abdomen) and the use of the plateau pressure to separate the resistance (high peak, normal plateau) from the compliance (high peak, high plateau) causes.
On this page
Study tools
Target exams
ANZCAFRCAABAEDAIC
Prompt
Thirty minutes into a laparotomy under volume-controlled ventilation, the peak airway pressure alarm sounds. The pressure has risen from 18 to 34 cmH2O. The saturation is 96 per cent. Assess and manage.
Presentation
Thirty minutes into an open laparotomy under the volume-controlled ventilation (the tidal volume 500 mL, the rate 12, the PEEP 5), the peak airway pressure alarm sounds. The peak pressure has risen from 18 to 34 cmH2O over five minutes. The saturation is 96 per cent, the capnograph is unchanged. The surgeon is retracting.
References1ShowHide
- [1]Jackson K, et al. Review of Anesthesia Versus Intensive Care Unit Ventilators and Ventilatory Strategies: COVID-19 Patient Management Implications. AANA Journal, 2021.PMID 33501910