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What is the cause of this post-extubation complication?

By: Rafael Araújo, Desenvolvedor de Softwares - 06/21/2017 09:50


A 38-year-old man presented with acute respiratory failure and pneumonia associated with a Chikungunya virus infection. He was intubated and evolved with a resolution of the infection, being extubated after passing a spontaneous breathing trial. It also had a MIP: -40cmH2O and a MEP: +10cmH2O. 

The chest x-ray was normal at the time.

About 2h after extubation, he presented respiratory discomfort and the following chest x-ray:


What are the findings of the chest x-ray?

What are the findings of the chest x-ray?

What is the most likely explanation for this complication?

What would be your diagnostic or therapeutic indications?


PS: case kindly provided by Dr. Ricardo Coelho Reis, pulmonologist, and intensivist, Head of the Pulmonology Service at the Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brazil

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