A 35-year-old man on mechanical ventilation for pneumonia suddenly develops severe dyspnea and hypotension. Vital signs show BP 85/50, HR 128, RR 32, SpO2 78% on FiO2 1.0. Physical examination reveals absent breath sounds on the left, distended neck veins, and tracheal deviation to the right. Chest X-ray shows leftward mediastinal shift with absent left-sided lung markings. There is no subcutaneous emphysema. Which of the following is the most likely diagnosis?
- A)Tension pneumothoraxGABARITO
- B)Pleural effusion
- C)Spontaneous pneumothorax
- D)Acute respiratory distress syndrome
- E)Pulmonary embolism
Explicação
Tension pneumothorax is correct. Acute respiratory distress with hypotension, unilateral absent breath sounds, and tracheal deviation away from the affected side is classic. Positive pressure ventilation is a major precipitating factor and immediate decompress... Ver explicação completa e trilha adaptativa →