What is that in the expiratory flow curve?

Last update: Monday, 23 Dec 2019 at 13:30

An attentive nurse brought to the attention of the on-call intensivist these findings observed in the flow-volume curves of a 36 year-old patient with a subarachnoid hemorrhage under mechanical ventilation in A/C - VCV mode.

Screen showing flow vs. time curves as well as the flow vs. volume curve

What is the most plausible explanation for what is shown here?

a) Coughing.
b) Expiratory muscle effort.
c) Tracheobronchial secretion in the tracheal tube.
d) Water, or condensation, in the expiratory limb of the ventilator circuit.

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