Doctor was called to the bedside of a patient because the nurse is concerned that the ventilator’s pressure alarm is now going off. This 65-year-old male patient was admitted for a COPD exacerbation and was intubated earlier in the day when he failed a trial of non-invasive ventilation. Earlier in the evening, the peak pressure was 45 cm H 2 O while the static pressure was 25 cm H 2 O. At the time she calls you, the peak pressure has risen to 60 cm H 2 0 and the static pressure is now 40 mm Hg. His heart rate has increased from 90 beats/minute to 110 beats/minute while his blood pressure has fallen from 110/85 to 90/70.
The physical exam is noteworthy for diminished breath sounds on the left side of the chest. Where do you think the problem lies with this particular patient? What management steps should you institute at this point? *This case is from Docplexus Editorial Team for…
