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- John C Grotberg, Bonnie R Wang, Richard Eakin, and Ivan N Co.
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI. Electronic address: grotberj@med.umich.edu.
- Chest. 2020 Jul 1; 158 (1): e1-e3.
AbstractA 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.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
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