[Intrinsic PEEP as a ventilation complication after pneumonectomy]

We report the case of a female patient who developed a clinical picture characterized by hemodynamic deterioration, bradycardia and asystole due to pulmonary hyperinsufflation (documented by X-ray examination) during the immediate postoperative phase of a right pneumonectomy. Occlusion of the respiratory limb of the respirator was followed by a positive pressure at the end of the respiration (PEEP) suggesting the presence of an intrinsic PEEP independent of the respirator. Application of a PEEP to the respirator induced a radiologic improvement. The mechanisms by which an intrinsic PEEP may develop are discussed.