[Faulty internal tube in a co-axial ventilation tube system: cause of a massive postoperative hypercapnia].

This article presents the case of a patient with massive postoperative hypercapnia during mechanical ventilation in the intensive care unit (ICU). With normal tidal volumes and clearly visible chest movements, adequate findings with regard to auscultation, oxygenation and correct respirator settings, no cause for the increasing hypercapnia was initially found; however, replacement of the respirator led to a return to normal carbon dioxide levels. When checking the replaced respirator a service technician found the cause of the respirator failure: the internal tube of the co-axial ventilation system was faulty leading to an increased dead space and rebreathing of carbon dioxide.