Localized tension pneumothorax: unrecognized form of barotrauma in adult respiratory distress syndrome.

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Abstract
Loculated [human] tension pneumothorax, usually localized in an inferior subpulmonic or paracardiac location, is a frequent complication of respiratory therapy in adult respiratory therapy in adult respiratory distress syndrome (ARDS) and may occur in spite of a functioning ipsilateral chest tube. The only radiographic evidence of tension may be slight flattening of the cardiac border and ipsilateral contour change or depression of the diaphragm. Severe cardiovascular and pulmonary compromise may result from a small volume of pleural air under tension and rapid recognition and drainage are required.

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