A patient is on mechanical ventilation in Intensive Care unit (ICU), ventilator show alarms for increase in both peak and plateau pressure during inspiration. This indicates:
Ans. (a) Obstruction of Tracheal tubeRef : Handbook of Mechnical ventilation 2nd ed.Complications of IntubationPerioperative* Esophageal intubation: This is a hazardous complication. If not detected in time, can cause severe hypoxia and even death.* Ischemia, edema and necrosis at local site (especially with red rubber tubes).* Aspiration (if cuff is not properly inflated).* Bronchial intubation and collapse of other lung.* Tracheal tube obstruction by secretions, kinking.* Accidental extubation* Trauma to gums, lip, epiglottis, pharynx, larynx and nasal cavity (in nasal intubation).* Reflex disturbances like laryngospasm, bronchospasm, breath holding.* Cardiac arrhythmias, hypertension or even cardiac arrest.
Obstruction of tracheal tube
Decrease in distensibility of lungs and chest wall
Acute bronchospasm
Increase compliance of lungs
Local and Regional Anesthesia