Sustained Mayer-Like Very-Low-Frequency Blood Pressure Oscillations in a 16-Year-Old After Drowning Associated Lung Injury.
Eli Shapiro, Eric Scheier
✦ AI-curated · Sources linked
Case in brief
A 16-year-old male with no prior health issues presented to the pediatric intensive care unit following drowning-associated lung injury, requiring mechanical ventilation for severe hypoxemia and pulmonary hemorrhage. Invasive arterial blood pressure monitoring revealed sustained Mayer-like very-low-frequency oscillations with a periodicity of approximately 28 seconds and amplitudes of 30-40 mm Hg. These oscillations persisted for about 12 hours and resolved prior to extubation.
What made this case unusual
The case is notable for the sustained, large-amplitude Mayer-like oscillations in blood pressure, which were not phase-locked to cardiac or ventilatory cycles and persisted despite interventions.
Diagnostic / clinical pearl
Clinicians should recognize that sustained Mayer-like oscillations in blood pressure may indicate intense autonomic activation following severe hypoxic events, rather than misclassifying them as artifact or arrhythmia.
Why it matters
Understanding these oscillations can enhance monitoring and management strategies in critically ill patients, particularly in the context of drowning-associated lung injury.