Open AccessCardiac Pacing a Rare Cause of Ventilator Auto Triggering
Author(s) -
Vimal K. Bhardwaj,
M Nithish Mukunthan
Publication year - 2022
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.5005/jp-journals-10071-24219
Subject(s) - medicine , heartbeat , mechanical ventilator , phrenic nerve , cardiology , anesthesia , intensive care medicine , respiratory system , mechanical ventilation , computer security , computer science
Ventilator auto triggering is an avoidable complication in ventilators, if left unnoticed can lead to deleterious effects. There are various causes for ventilator auto triggering. Though rare, there are some cardiac causes for inadvertent ventilator triggering. We report a case of 44-years-old male paced with atrial epicardial wires postcoronary artery bypass. The wires were close to the right phrenic nerve, causing the right diaphragm to contract in synchronization with the heartbeat. This caused ventilator auto triggering and ended up delivering inadvertent breaths. The pacemaker output was immediately reduced to the required minimum to continue pacing the heart and decrease phrenic nerve stimulation. This caused immediate changes in ventilator waveform and auto triggering was completely stopped and the patient could be successfully weaned off the ventilator. This case report emphasizes he need for timely recognition of alteration in ventilator waveforms and early intervention to avert any untoward events.