Tension Pneumoperitoneum in Association with Tension Pneumothorax

摘要

A 73-year-old woman, with a lifelong history of bronchial asthma, was intubated due to severe respiratory distress. The patient was very difficult to ventilate because of severely obstructed airways and noncompliant lungs. In a volume control mode of ventilation with an initial V_T of 8 ml/kg ideal body weight (520 ml), frequency 14/minute, inspiratory to expiratory ratio of 1:2.5, and inspiratory flow rate of 35 L/minute, the peak inspiratory pressures were 55-65 cm H_2O, inspiratory resistance 35-45 cm H_2O/L/second, plateau pressures 35 cm H_2O, and static compliance 15 ml/cm H_2O. One hour after the initiation of ventilatory support, abdominal distention was noticed.