#Lazarus syndrome manual
Dynamic hyperinflation can theoretically happen in any situation where rapid manual ventilation is carried out. It is tempting to apply this theory even to patients without obstructive airways disease. Some authors recommend discontinuing the ventilation transiently for 10 to 30 seconds in PEA to allow venous return.
Hypovolaemia and decreased myocardial contractility could exaggerate its effect on venous return and cardiac output. Auto-PEEP is a possible cause of pulseless electrical activity (PEA), and rapid ventilation during CPR should be avoided. The physiology of severe auto-PEEP is similar to pericardial tamponade, where circulation can only be restored after removing the obstacle to cardiac filling. The ventilator was adjusted to a respiratory rate of six breaths per minute and a tidal volume of 400 mL and the blood pressure gradually rose to 126/84 mm Hg.
Even after inotropes the systolic blood pressure did not exceed 70 mm Hg. 31 One report describes a patient with respiratory failure due to asthma whose blood pressure was undetectable five minutes after initiating artificial ventilation with a tidal volume of 700 mL and respiratory rate of 25 breaths per minute. The link between mechanical ventilation of patients with obstructive ventilatory defects and circulatory failure was first demonstrated in 1982. Dynamic hyperinflation may lead to gas trapping and an increase in the end-expiratory pressure (called auto-PEEP) leading to delayed venous return, low cardiac output and even cardiac arrest in patients with obstructive airways disease.
Rapid manual ventilation without adequate time for exhalation during CPR can lead to dynamic hyperinflation of lungs.
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