Because of their daily experience with airway and respiratory problems, physicians practicing anesthesia have become popular "resuscitationists." As such, they have learned that most patients improve dramatically with institution of large volume, mechanical ventilation. As with all forms of treatment in medicine, this form of therapy may give undesirable results on some occasions. The following case is an example.
Report of a Case
Following an uncomplicated pregnancy, a 19-year-old primigravida, while under pudendal block, delivered without problems a 2.5 kg baby boy. The baby was markedly depressed, however, with a one minute Apgar score of one (pulse rate less than 100). Positive pressure ventilation was instituted via a mask from a resuscitation apparatus with 100% oxygen. At a peak inspiratory pressure of 20 cm water, no breath sounds could be heard, and no movement of the chest wall was evident. The pulse rate did increase to 120, however, so the