Pulmonary barotrauma during cardiopulmonary resuscitation.

Despite the large variety of ventilatory equipment and conditions under which CPR is performed, there have been few cases of pulmonary barotrauma, which is surprising since the transpulmonary pressures developed during CPR are relatively high. This report cites four cases demonstrating different mechanisms by which pulmonary barotrauma can be caused during CPR, and reviews their pathophysiologic consequences. The suggested levels of transpulmonary pressure needed for effective simultaneous chest compression and ventilation are even higher than those used for conventional CPR and are likely to contribute to the incidence of barotrauma during CPR.