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(Chest. 2002;121:284-286.)
© 2002 American College of Chest Physicians

Management of Tension Pneumatocele With High- Frequency Oscillatory Ventilation*

Hsiu-Nien Shen, MD; Frank Leigh Lu, MD; Huey-Dong Wu, MD; Chong-Jen Yu, MD, PhD, FCCP and Pan-Chyr Yang, MD, PhD, FCCP

* From the Departments of Internal Medicine and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Correspondence to: Chong-Jen Yu, MD, PhD, FCCP, Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Rd, Taipei, Taiwan 100; e-mail: jeffery{at}ha.mc.ntu.edu.tw

We report the successful application of high-frequency oscillatory ventilation in a patient with tension pneumatocele (TP). The proposed check-valve mechanism for the development of pneumatoceles predicts that positive-pressure ventilation could lead to distension of these airspaces and formation of TPs. Therefore, high-frequency ventilation could be more applicable in conditions, such as massive air leak due to bronchopleural fistula, that are difficult to manage by conventional ventilator modes.

Key Words: bronchopleural fistula • high-frequency oscillatory ventilation • pneumatocele • Streptococcus pneumoniae




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