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Respiratory Distress in the Ventilated ED Patient
- In the ventilated patient with respiratory distress, evaluation of peak and plateau pressures can help to identify the cause.
- Isolated increases in peak pressure suggest increased resistance to airflow and should prompt consideration of the following:
- kinked or twisted ET tube
- patient biting ET tube
- obstructed ET tube
- bronchospasm
- lower airway obstruction
- Increases in plateau pressure suggest decreased pulmonary compliance and should prompt consideration of the following:
- unilateral intubation
- pneumothorax
- pulmonary edema
- worsening pneumonia
- abdominal HTN/compartment syndrome
References
Santanilla JI, Daniel B, Yeow ME. Mechanical ventilation. Emerg Med Clin N Am 2008;26:849-862.