A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side.  Where do you think the problem lies with this particular patient?

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A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side.  Where do you think the problem lies with this particular patient?
Selected Answer: Given the patient’s increased peak pressure and statistic pressure, he is likely having a change in the compliance of his respiratory system. The cause of the altered compliance is likely to be tension pneumothorax, as evidenced by diminished breath sounds on the left, tachycardia and hypotension. Correct Answer: Correct  This patient has had increases in both the peak and static pressures suggestion this patient has a new “compliance” problem. A patient with COPD who develops unilateral decreased breath sounds, tachycardia, and hypotension while on mechanical ventilation should be suspected that he has developed a tension pneumothorax. Response Feedback: [None Given]

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