Cardiogenic Auto-Triggering as a Consequence of Hemoperitoneum.

Grotberg, John C; Wang, Bonnie R; Eakin, Richard; Co, Ivan N · Chest · 2020

case_report · Level V

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Abstract

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.

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