Iatrogenic pneumothorax during anesthesia remains uncommon but can occur as a result of elevated airway pressures in the setting of anesthesia and airway management. Infants, because of their small size and highly compliant chest, are at greater risk of lung trauma from even briefly elevated airway pressures.1 The oxygen flush valve is sometimes used to rapidly refill the bag for manual ventilation or the ventilator bellows. When open, it delivers oxygen at high pressure at a rate of 35 to 75 l/min.2 If the valve is open during mechanical ventilation, the airway pressure can reach as high as 70 cm H2O as the pressure-limiting valve of an operating room ventilator is usually set at 70 cm H2O. If it is open in spontaneous breathing mode or during manual bag ventilation, the airway pressure can reach 68 cm H2O if the adjustable pressure-limiting...
Too Much of a Good Thing: Iatrogenic Pediatric Pneumothorax from Engagement of the Oxygen Flush Valve
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Published online first on December 1, 2021.
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Shelly H. Pecorella, L. Daniela Smith, Timothy E. Smith, T. Wesley Templeton; Too Much of a Good Thing: Iatrogenic Pediatric Pneumothorax from Engagement of the Oxygen Flush Valve. Anesthesiology 2022; 136:326 doi: https://doi.org/10.1097/ALN.0000000000004085
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