Tension Pneumothorax Tension pneumothorax occurs when a one-way valve develops in the injured lung and allows entry of air into the pleural space during inspiration without being able to escape during expiration. Tension physiology occurs when the increased intrathoracic pressure (15 to 20 mm Hg) limits the return of venous blood flow from the body to the right heart and compresses the great ve...

Cricothyroidotomy can be a life-saving procedure for the "can't intubate, can't ventilate" patient who has upper-airway obstruction. The procedure is usually fast and easy to do; however, complications have been reported. We report two cases in which cricothyroidotomy with an endotracheal tube led to unrecognized endobronchial intubation, ipsilateral tension pneumothorax, contralateral presumed...

The case is a 48-year-old female who presented with mild dyspnea on exertion and cough with unremarkable vital signs and was found to have a large right sided pneumothorax. She underwent small bore chest tube decompression with immediate reexpansion of the collapsed lung. However, she rapidly developed moderate hypoxemia and radiographic evidence of reexpansion pulmonary edema (REPE) on both th...

Using a single-lumen tracheal tube, collapse of the nonventilated lung can be achieved by carbon dioxide insufflation into the contralateral closed intrapleural chest cavity to a pressure as low as 5 mmHg. However, this technique may create a physiological response very similar to that of a unilateral tension pneumothorax, with a consequent hemodynamic instability secondary to decreased venous ...

The placement of central venous catheters (CVCs) has become a ubiquitous practice in intensive care units (ICUs). The use of CVCs is often a necessity for the measurement of hemodynamic variables and the administration of fluids, medications, blood products, and parenteral nutrition in critically ill patients; however, catheterization may occasionally be associated with complications, such as p...