A 52-year-old man on ICU with ARDS develops a tension pneumothorax on the right side during high-PEEP ventilation. After emergency needle decompressio...

Question

A 52-year-old man on ICU with ARDS develops a tension pneumothorax on the right side during high-PEEP ventilation. After emergency needle decompression and chest drain insertion, the team notes the ventilator shows PEEP 14 cmH2O on the left side. An important consideration when managing unilateral pathology in a patient on bilateral PEEP is:

Accepted Answer

Consideration should be given to the fact that the applied PEEP may now cause overdistension of the remaining (non-pneumothorax) lung while being transmitted through the chest drain on the affected side - close monitoring of compliance and tidal volume is essential

Answer

PEEP should be increased to compensate for the lost lung

Answer

PEEP should be set to zero on both sides

Answer

The chest drain should be clamped to prevent PEEP loss

Answer

Independent lung ventilation is never required

uk-fficm MCQ (SBA): Pneumothorax During PEEP Ventilation