Lung hyperinflation caused by inappropriate ventilation resulting in electromechanical dissociation: a case report

Lung hyperinflation has been demonstrated to occur in patients with obstructive lung disease requiring mechanical ventilation. A dramatic case of pulmonary hyperinflation occurred in the early resuscitative period after initial intubation and manual ventilation leading to the development of electromechanical dissociation. Once the presence of lung hyperinflation was recognized, manipulation of the patient's ventilator settings allowed resolution of the lung hyperinflation and reversal of the detrimental hemodynamic effects it produced. This case illustrates that lung hyperinflation should be included in the differential diagnosis of electromechanical dissociation. In selected patients if pneumothorax, hypovolemia, cardiac tamponade, and myocardial infarction are excluded as causes and pulmonary hyperinflation is suspected, then a trial of adjusted ventilation to decrease the lung hyperinflation may be useful.