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This is classic dynamic hyperinflation (auto-PEEP) causing reduced venous return and hypotension. A transient circuit disconnect lets trapped gas escape, immediately lowering intrathoracic pressure and restoring preload. Then adjust the ventilator: lower rate, reduce tidal volume if needed, and increase inspiratory flow to shorten inspiratory time, thereby lengthening expiratory time. Continue aggressive bronchodilation and consider ketamine for bronchodilation/sedation. Increasing PEEP (C) risks raising total PEEP in severe obstruction. Raising RR (A) shortens expiratory time and worsens trapping. Bicarbonate (D) treats severe acidemia but doesn’t resolve the mechanical cause. Reassess with an end-expiratory hold to quantify auto-PEEP, track EtCO₂ waveform (“shark-fin” improvement), and monitor hemodynamics closely; repeat the brief disconnect only if life-threatening and with high FiO₂ preoxygenation.