Transient decrease in PaCO2 and asymmetric chest wall dynamics in early progressing pneumothorax

Abstract

The counterintuitive transient prolonged decrease in CO(2) without changes in SpO(2) may explain the delay in diagnosis of PTX encountered in the clinical environment. An earlier indication of asymmetrically decreased ventilation on the affected side was achieved by monitoring the TDi.

Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients

“…The authors continuously recorded the hemodynamic parameters, VT, EtCO2, SpO2, blood gases, and chest wall tidal displacements (TDi) on both sides of the chest. The finding that a counterintuitive transient prolonged the decrease in CO 2 without changes in SpO2 probably explains the delay in diagnosis of pneumothorax encountered in newborn infants [17].…”

“…Waisman et al [17] performed an animal study of progressive pneumothorax induced in rabbits. The authors continuously recorded the hemodynamic parameters, VT, EtCO2, SpO2, blood gases, and chest wall tidal displacements (TDi) on both sides of the chest.…”