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Respiratory Failure & Mechanical Ventilation

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47 years old female with status asthmatics who got intubated and placed on mechanical ventilation. An inspiratory hold was applied as shown in this snapshot of the ventilator screen:

Notice the limitation of the expiratory flow in the first breath before the inspiratory hold. Also notice that the peak pressure is elevated at 46 cm H2O, the plateau is elevated at 30 cm H2O and the difference is at 16 cm H2O representing the increased airway resistance due to bronchospasm.

What is the most likely explanation of the increased plateau pressure in this asthmatic patient?

  • 0%Pneumonia

  • 0%Pneumothorax

  • 0%AutoPEEP

  • 0%Lung collapse

You can vote for more than one answer.

What would you do next to confirm your diagnosis?

Despoina  Papachristou
Mouhmad Jamil
mustafa sulaiman
suray Bakkar
Mazen Kherallah
Mazen Kherallah
Dec 23, 2023

Here is a screenshot of the ventilator waveforms of the pressure, flow, and volume over time in this patient prior the the inspiratory and expiratory hold.



Expiratory hold maneuver with auto-PEEP and three inspiratory efforts by the patient, the last with an occlusion pressure of 17 cm H2O. @Everyone

Nawar Halim
Abdulrazak Sakhakhni
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