64 years old male who is a heavy smoker with COPD and laryngeal carcinoma, s/p tracheostomy. He is addmitted now to the ICU complaining of air hunger. When connected to the ventilator; it showed the waves you see and the patient felt suffocation. Unfortunately, this is the only screenshot that was provided by Dr. Abdulhaseeb Tarabulsi.
![](https://static.wixstatic.com/media/e4917c_a697700c8cd94766ab53750565ed138d~mv2.jpg/v1/fill/w_125,h_101,al_c,q_80,usm_0.66_1.00_0.01,blur_2,enc_auto/e4917c_a697700c8cd94766ab53750565ed138d~mv2.jpg)
Knowing that this is not a ventilator malfunction or circuit disconnection, what do you thing is happening?
With this huge leak, I think tracheo-bronchial fistula is very likely and should be investigated