Ivey H H, Kattwinkel J, Alford B A
Am J Dis Child. 1981 Jun;135(6):544-6. doi: 10.1001/archpedi.1981.02130300044015.
We reviewed our cases of persistent extrapulmonary air following chest tube placement and decided to test the hypothesis that this entity may represent collections of air beneath the visceral pleura. We describe ten patients who had this entity despite one or more chest tubes per pleural cavity, and described the creation of subvisceral pleural blebs in preterm lambs with respiratory distress requiring mechanical ventilation. We conclude that (1) subvisceral pleural air may occur in infants with respiratory distress and, thus, may be inaccessible to chest-tube drainage, and (2) centrifugal dissection of air, though poorly appreciated previously, may play an important role in the pathogenesis of extrapulmonary air.
我们回顾了胸腔置管后出现持续性肺外气体的病例，并决定检验这样一个假设，即该实体可能代表脏层胸膜下的气体积聚。我们描述了10例尽管每个胸腔放置了一根或多根胸管仍出现该实体的患者，并描述了在患有呼吸窘迫需要机械通气的早产羔羊中创建脏层胸膜下气泡的过程。我们得出结论：（1）呼吸窘迫的婴儿可能会出现脏层胸膜下气体，因此胸管引流可能无法触及；（2）气体的离心性剥离，尽管以前认识不足，但可能在肺外气体的发病机制中起重要作用。
