• J Intensive Care Med · Jan 2003

    Review

    Pneumothorax in patients with acute respiratory distress syndrome: pathophysiology, detection, and treatment.

    • Kenneth J Woodside, Eric vanSonnenberg, Kenneth S Chon, David B Loran, Irena M Tocino, and Joseph B Zwischenberger.
    • Division of Cardiothoracic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
    • J Intensive Care Med. 2003 Jan 1;18(1):9-20.

    AbstractPneumothorax is a frequent and potentially fatal complication of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). Prompt recognition and treatment of pneumothoraces is necessary to minimize morbidity and mortality. The radiologic and clinical signs of pneumothoraces in ARDS patients may have unusual and subtle features. Furthermore, small pneumothoraces in these patients can cause severe hemodynamic or pulmonary compromise. Sparse clinical literature exists on when or how to treat pneumothoraces once they develop in patients with ARDS. In this article, the authors review the pathogenesis, radiologic signs, clinical significance, and treatment of pneumothoraces in ARDS patients. Treatment options include traditional tube thoracostomy, open thoracotomy, and image-guided percutaneous catheters.

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