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Severe pulmonary barotrauma.

M D Reid-Nicholson¹, C T Escoffery

¹Department of Pathology, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica.

The West Indian Medical Journal

|February 24, 2001

Summary

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Pulmonary barotrauma, a rare complication of mechanical ventilation, can occur during cardiopulmonary resuscitation (CPR) due to faulty Ambu bag valves. This case highlights a potential risk of airway pressure injury during emergency procedures.

Area of Science:

Medicine
Pulmonology
Critical Care

Background:

Mechanical ventilation can lead to pulmonary barotrauma, characterized by alveolar rupture due to excessive pressure.
Self-inflating bag-ventilation devices, commonly used in cardiopulmonary resuscitation (CPR), carry a rare risk of barotrauma.

Observation:

A case of severe pulmonary barotrauma occurred during routine CPR.
The event was associated with the one-way valve of an "Ambu" bag device malfunctioning.
The valve was observed to be locked in the inspiratory position.

Findings:

The malfunctioning valve likely caused sustained positive pressure ventilation.
This sustained pressure led to alveolar rupture and subsequent pulmonary barotrauma.
The specific mechanism involved the inspiratory phase of the Ambu bag being inadvertently prolonged.

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Implications:

Highlights a rare but serious complication of CPR using bag-valve devices.
Suggests the need for vigilance regarding the function of one-way valves in resuscitation equipment.
Underscores the importance of proper technique and equipment checks during emergency ventilation to prevent barotrauma.