Delayed tracheal extubation after cardiac surgery due to cardiogenic ventilator auto-triggering: a case report

JA Clinical Reports

Kazuyoshi Hirota¹  Satoshi Uchida¹  Daiki Takekawa¹ 

[1] Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, 036-8562, Hirosaki, Japan;

关键词: Ventilator auto-triggering;    Cardiogenic oscillation;    Delayed tracheal extubation;   

DOI  :  10.1186/s40981-021-00458-4

来源: Springer

【 摘 要 】

BackgroundVentilator auto-triggering is associated with poor outcomes. Herein, we present a case of delayed tracheal extubation after cardiac surgery due to cardiogenic auto-triggering.Case presentationA 73-year-old male with chronic constrictive pericarditis underwent radical pericardiectomy. After confirming hemodynamic stability, we conducted spontaneous breathing trial (SBT) with a flow-trigger sensitivity of 1 L/min. As his respiratory rate (RR) increased to more than 60 breaths/min and tidal volume decreased to less than 100 mL, this SBT was considered a failure. Next morning, SBT was reperformed and the result was unchanged. However, we noticed that his heart rate and RR were the same and suspected auto-triggering caused by cardiogenic oscillations. We changed ventilator mode from flow triggering to pressure triggering of −2 cmH2O and he was uneventfully extubated.ConclusionWe experienced a case of delayed tracheal extubation after cardiac surgery due to cardiogenic auto-triggering. Auto-triggering can be reduced by changing ventilator trigger mode.

【 授权许可】

CC BY