Document Detail

Cardiovascular collapse associated with extreme iatrogenic PEEPi in patients with obstructive airways disease.
MedLine Citation:
PMID:  10655931     Owner:  NLM     Status:  MEDLINE    
Chronic obstructive pulmonary disease (COPD) is commonly associated with positive alveolar pressure at end-expiration (intrinsic PEEP or PEEPi) caused by a prolonged expiratory time constant. Positive pressure ventilation (PPV) with large tidal volumes and high ventilatory frequencies may cause pulmonary hyperinflation, with increases in intrathoracic pressure and cardiopulmonary effects. We report two cases, one of fatal pulseless electrical activity, the other of life-threatening hypotension, both during vigorous manual PPV, in patients with severe COPD. This phenomenon has been well-recognized by intensivists but is reported poorly more widely.
L E Connery; M J Deignan; M W Gujer; M G Richardson
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  83     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1999 Sep 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  493-5     Citation Subset:  IM    
Department of Anesthesiology, University of Wisconsin, Madison 53792, USA.
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MeSH Terms
Fatal Outcome
Hypotension / etiology
Lung Diseases, Obstructive / complications*
Positive-Pressure Respiration, Intrinsic / complications*
Shock / etiology*

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