Case Reports in Critical Care

Case Report

Esophageal Balloon-Directed Ventilator Management for Postpneumonectomy Acute Respiratory Distress Syndrome

Table 1

Patient clinical characteristics and ventilator parameters during his intensive care unit stay.


Patient characteristic	POD #0	POD #5	POD #8	POD #11	POD #12	POD #13	POD #14	POD #16	POD #18

Clinical parameters
Actual weight, kg	87.5	93	99.5	98	98.7	102.9	98.1	96.8	92.6

Respiratory parameters
Ventilator model	PB 840	PB 840	PB 840	PB 840	Hamilton G5	Hamilton G5	Hamilton G5	Hamilton G5	Hamilton G5
Ventilator mode	PCV	PCV	PCV	PCV	APVcmv	APVcmv	APVcmv	APVcmv	APVcmv
Set pressure control	14	18	16	15	-	-	-	-	-
Actual tidal volume, mL	380	425	417	521	410	320	320	346	542
Actual tidal volume, mL/kg PBW	4.3	4.8	4.7	5.9	4.7	3.6	3.6	3.9	6.2
Set respiratory rate, breaths/min	24	26	18	10	24	28	28	22	22
Actual respiratory rate, breaths/min	24	26	19	17	24	28	28	26	26
Minute ventilation, L/min	9.6	10.6	8.7	7.9	9.8	9.0	9.0	9.0	8.9
FiO₂	0.50	0.50	0.70	0.80	0.80	0.50	0.35	0.40	0.35
pH	7.35	7.36	7.29	7.27	7.37	7.29	7.38	7.44	7.44
PaCO₂, mm Hg	52	51	75	84	63	71	67	58	52
PaO₂, mm Hg	130	80	67	82	76	77	85	88	71
HCO₃, mmol/L	27	28	32	34	35	31	37	37	35
PaO₂ : FiO₂, mm Hg	260	160	96	103	95	154	243	220	203

Airway pressure, cm H₂O
Plateau	-	-	-	-	28	28	26	16	-
Peak	23	29	32	32	35	32	28	23	17
Mean	14	17	20	21	21	23	22	15	15
Set PEEP, cm H₂O	8	10	14	14	14	18	18	12	12
Intrinsic PEEP, cm H₂O	-	-	-	-	1	0	0	0	-
, cm H₂O	-	-	-	-
At end-inspiration	-	-	-	-	17	18	14	-	-
At end-expiration	-	-	-	-	15	17	13	-	-
, cm H₂O	-	-	-	-
At end-inspiration	-	-	-	-	11	10	12	-	-
At end-expiration	-	-	-	-	0	1	5	-	-
Airway driving pressure, cm H₂O	-	-	-	-	13	10	8	4	-
Transpulmonary driving pressure, cm H₂O	-	-	-	-	11	9	7	-	-
Respiratory system compliance, mL/cm H₂O	-	-	-	-	32	32	40	87	-
Lung compliance, mL/cm H₂O	-	-	-	-	37	36	46	-	-
Chest wall compliance, mL/cm H₂O	-	-	-	-	205	320	320	-	-

Cointerventions
Prone positioning	No	No	No	No	Yes	Yes	Yes	No	No
Neuromuscular blockade	No	No	No	No	Yes	Yes	Yes	No	No

Abbreviations: APVcmv: adaptive pressure ventilation continuous mandatory ventilation; PB: Puritan Bennett; PCV: pressure-controlled ventilation; : esophageal pressure; : transpulmonary pressure; POD: post-operative day; -: not measured or recorded in the chart.