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Decreased cardiac index as an indicator of tension pneumothorax in the ventilated patient
Author(s) -
BEARDS S. C.,
LIPMAN J.
Publication year - 1994
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1994.tb03371.x
Subject(s) - medicine , tension pneumothorax , cardiac index , pneumothorax , anesthesia , central venous pressure , ventilation (architecture) , blood pressure , hemodynamics , inotrope , mechanical ventilation , cardiac output , heart rate , cardiology , surgery , mechanical engineering , engineering
Summary We describe three critically ill patients receiving pressure‐controlled ventilation who suffered acute hypotensive episodes associated with the development of tension pneumothoraces. In four documented episodes of tension pneumothorax a major decrease in cardiac index was the most consistently detected abnormality. The expected increases in central venous pressure and heart rate did not occur in three of the episodes in two of the patients, both of whom were receiving inotropic therapy. Any increases in airway pressure could not be assessed on pressure‐controlled ventilation. The physiology of tension pneumothorax in the ventilated patient is described and the importance of decreased cardiac index as a haemodynamic indicator of tension pneumothorax is discussed.