| Manifestations | - Elevated airway pressure on gauge
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- Increased slope of pressure-volume loop
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- "Tidal volume not delivered, pressure limit" alarm message
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| Potential causes | |
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- Surgical peritoneal insufflation
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- Intentional single lung ventilation
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- Pneumothorax, especially tension pneumothorax
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- Airway obstruction by mucous, blood, foreign body
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- Kinked or obstructed endotracheal tube
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- Increased delivered tidal volume
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- High fresh gas flow rate with uncompensated ventilator
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- Oxygen flush during inspiration
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- Breath-stacking due to inadequate expiratory time
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- Obstructed breathing system at inspiratory hose
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- Improperly placed equipment such as PEEP valve or humidifier
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| Suggested responses | - Check patient (look for movement and signs of coughing, observe patient chest movement, auscultate lungs)
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- Look at shape of airway pressure curve and expiratory portion of flow-volume loop (to differentiate high resistance from low compliance)
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- Look at shape of capnogram (to diagnose small airway resistance)
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- Pass suction catheter down endotracheal tube (to detect kink, mucous plug, or other obstruction)
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