We found a higher incidence of venous catheter-related pneumothorax among patients undergoing ED positive pressure ventilation.
Positive pressure ventilation contributes to the development of pneumothorax in 2 ways.
First, barotrauma from positive pressure ventilation alone can cause pneumothorax, independent of iatrogenic pleural
violation during central venous catheterization [3].
This occurs more commonly in patients with underlying chronic pulmonary disease
[48].
Second, positive pressure ventilation can enlarge the size of pneumothoraces, even transforming what would have been occult abnormalities into pneumothoraces sufficiently large to be detectable by plain chest radiograph [34].
Such a process also has been demonstrated in patients with traumatic pneumothoraces [20]. Positive pressure ventilation
also increases the risk for tension pneumothorax, which is why drainage of even small pneumothoraces is customarily recommended in mechanically ventilated patients [48,49]. A pneumothorax in a mechanically ventilated patient carries a greater risk of serious barotrauma, which can even be life threatening [50].
We found a higher incidence of venous catheter-related pneumothorax among patients undergoing ED positive pressure ventilation.Positive pressure ventilation contributes to the development of pneumothorax in 2 ways. First, barotrauma from positive pressure ventilation alone can cause pneumothorax, independent of iatrogenic pleuralviolation during central venous catheterization [3]. This occurs more commonly in patients with underlying chronic pulmonary disease[48]. Second, positive pressure ventilation can enlarge the size of pneumothoraces, even transforming what would have been occult abnormalities into pneumothoraces sufficiently large to be detectable by plain chest radiograph [34]. Such a process also has been demonstrated in patients with traumatic pneumothoraces [20]. Positive pressure ventilationalso increases the risk for tension pneumothorax, which is why drainage of even small pneumothoraces is customarily recommended in mechanically ventilated patients [48,49]. A pneumothorax in a mechanically ventilated patient carries a greater risk of serious barotrauma, which can even be life threatening [50].
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