Cardiogenic Auto-Triggering as a Consequence of Hemoperitoneum

A 70-year-old woman presented with hemorrhagic shock secondary to hemoperitoneum following a paracentesis. On hospital day 3, she developed respiratory alkalosis and increased respiratory rates observed on the ventilator despite no spontaneous inspiratory effort. Converting to pressure support mode...

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Bibliographic Details
Published in:	Chest Vol. 158; no. 1; pp. e1 - e3
Main Authors:	Grotberg, John C., Wang, Bonnie R., Eakin, Richard, Co, Ivan N.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2020
Subjects:	auto-triggering cardiogenic oscillations flow-triggering hemoperitoneum hemoperitoneum flow-triggering cardiogenic oscillations auto-triggering
Online Access:	Get full text
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Summary:	A 70-year-old woman presented with hemorrhagic shock secondary to hemoperitoneum following a paracentesis. On hospital day 3, she developed respiratory alkalosis and increased respiratory rates observed on the ventilator despite no spontaneous inspiratory effort. Converting to pressure support mode uncovered a cardiogenic oscillatory flow that had been auto-triggering the ventilator. This cardiogenic auto-triggering resolved with large-volume paracentesis. Cardiogenic auto-triggering leads to patient-ventilator dyssynchrony, respiratory alkalosis, lung distension, and difficulty with weaning from the ventilator, and it may be unrecognized in ICUs.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0012-3692 1931-3543
DOI:	10.1016/j.chest.2020.03.023