Chronic Respiratory Failure and Long-Term Mechanical Ventilation Denise M. Goodman Steven O. Lestrud Epidemiology There are continual improvements in invasive (ventilation through a tracheostomy) and noninvasive (mask ventilation) devices and management to care for those conditions predisposing to the need for chronic…
Pulmonary function is influenced by the structure of the chest wall (see Chapter 400 ). Chest wall abnormalities can lead to restrictive or obstructive pulmonary disease, impaired respiratory muscle strength, and decreased ventilatory performance in response to physical stress. The…
Bronchopulmonary Dysplasia Bronchopulmonary dysplasia (BPD) is a chronic lung disease of infancy and childhood that occurs primarily in preterm infants born at less than 32 wk gestation. BPD is characterized by alveolar hypoplasia, often with concomitant small airway dysfunction and impaired…
Chylothorax is a pleural collection of fluid formed by the escape of chyle from the thoracic duct or lymphatics into the thoracic cavity. Etiology Chylothorax in children occurs most frequently because of thoracic duct injury as a complication of cardiothoracic…
Hemothorax, an accumulation of blood in the pleural cavity, is rare in children. Etiology Bleeding into the chest cavity most commonly occurs after chest trauma, either blunt or penetrating. It can be the result of iatrogenic trauma, including surgical procedures…
Hydrothorax is a transudative pleural effusion; typically, it is caused by abnormal pressure gradients in the lung. Etiology Hydrothorax is most often associated with cardiac, renal, or hepatic disease. It can also be a manifestation of severe nutritional edema and…
Air or gas in the mediastinum is called pneumomediastinum. Etiology Pneumomediastinum is typically caused by alveolar rupture which can be due to either a spontaneous or traumatic cause. A spontaneous pneumomediastinum can either be primary without an underlying etiology or…
Pneumothorax is the accumulation of extrapulmonary air within the chest, most commonly from leakage of air from within the lung. Air leaks can be primary or secondary and can be spontaneous, traumatic, iatrogenic, or catamenial ( Table 439.1 ). Pneumothorax…
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Atelectasis is the incomplete expansion or complete collapse of air-bearing tissue, resulting from obstruction of air intake into the alveolar sacs. Segmental, lobar, or whole lung collapse is associated with the absorption of air contained in the alveoli, which are…