Unilateral lung hyperinflation and herniation as a manifestation of intrinsic PEEP.
In a 64-year-old ventilated patient with severe chronic obstructive pulmonary disease and extensive unilateral pneumonia, intrinsic PEEP became recognized when the chest roentgenogram showed unilateral lung hyperinflation and herniation of a large bulla to the contralateral hemithorax. The use of an on-line suction catheter may have contributed to the development of intrinsic PEEP. Removal of the catheter resulted in roentgenographic and clinical improvement.
Eveloff
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Division of Pulmonary and Critical Care Medicine, Rhode Island Hospital, Providence 02903.
Rounds
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Braman
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D006547:Hernia / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011859:Radiography; D012121:Respiration, Artificial / Q000009:adverse effects*