Chest X-ray showing a mass lesion in the left upper and middle zones
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IPPV is invasive and non-physiological, and hence reserved for cases where non-invasive ventilation is not suitable.

Terminology

PEEP: positive end expiratory pressure
Cycling: change from inspiration to expiration or the reverse. It can be volume cycled, pessure cycled, time cycled or flow cycled.
Modes of ventilation: controlled mode, assist controlled mode, assist mode
Controlled mode – every breath by the ventilator; even if the subject wants breath spontaneously, it is not permitted. Volume and pressure controlled modes are available.
Assist control mode – IMV and SIMV (synchronized intermittent mandatory ventilation). SIMV removes the chance of fighting …

Oxygen therapy can be normobaric or hyyperbaric. During oxygen therapy, ventilation and airway maintenance should be adequate so that oxygen reaches the lung for gas exchange. Reserve of oxygen in the body is 1.5 litres, which lasts for about 6 minutes in circulatory arrest assuming a consumption of 250 ml/min. Hb contains 800 ml and alveoli contains about 400 ml of oxygen. Pre-oxygenation prior to induction of anaesthesia leads to denitration and increase in the alveolar oxygen content, enabling tolerance of longer period of apnea.
Circulatory gradient of oxygen: Oxygen …

Continuos diaphragm sign in pneumomediastinum
Continuos left hemidiaphragm sign in lateral view
Air anterior to heart in pneumomediastinum
Halo sign in pneumopericardium

Swine Influenza A outbreak has started in March, 2009 in Mexico. The number of suspected cases has increased to about 2000 while the death toll is increasing. Confirmed cases has been reported from the United States, Spain, Scotland and Canada. World Health Organization has increased the pandemic alert level from 3 to phase 4, meaning that “that the likelihood of a pandemic has increased, but not that a pandemic is inevitable”. Human to human transmission has evolved as cases without any contact with swine what so ever have occurred.
Swine Influenza …

Vesicular breath sounds refers to the breath sounds heard over the various lung areas. The term ‘vesicular breath sounds’ was coined by Lennac. It was named so due to the belief that they are produced by air flowing through the alveoli. But it a misnomer. Vesicular breath sounds are in fact produced by the air flowing through the bronchi and the bronchioles. But they have a different character (low intensity, low pitch, expiratory phase lasting 1/3 of inspiration with no gap between expiration and inspiration) from the bronchial breath sounds …

Tracheal air column is seen shifted to right on X-ray chest PA view. It indicates a loss of volume of the right upper lobe of the lung, either due to collapse or fibrosis. Tracheal can also be pushed to the right due to a massive pleural effusion on the left side. But no pleural effusion is seen on the left side.

Click on the image for an enlarged view
Homogenous opacity with higher level towards the axilla on the left side is characteristic of a large pleural effusion on the left side. Tracheal and mediastinal shift to the right side is also evident. Pleural effusion can be either a transudate as in heart failure or exudate as in infections, inflammatory disorders or malignancy. Transudate is identified as a clear fluid with low protein and cell content. Exudate is straw coloured and has high protein and cell count. Hemorrhagic effusion is seen in …