@article {Leray770, author = {V{\'e}ronique Leray and Gael Bourdin and Ghislain Flandreau and Fr{\'e}d{\'e}rique Bayle and Florent Wallet and Jean-Christophe Richard and Claude Gu{\'e}rin}, title = {A Case of Pneumomediastinum in a Patient With Acute Respiratory Distress Syndrome on Pressure Support Ventilation}, volume = {55}, number = {6}, pages = {770--773}, year = {2010}, publisher = {Respiratory Care}, abstract = {During mechanical ventilation for acute respiratory distress syndrome, tidal volume (VT) must be reduced. Once switched to pressure-support ventilation, there is a risk that uncontrolled large VT may be delivered. A 63-year-old man with community-acquired pneumonia required tracheal intubation and mechanical ventilation, with a VT of 6 mL/kg predicted body weight, PEEP of 10 cm H2O, a respiratory rate of 30 breaths/min, and FIO2 of 0.60. Plateau pressure was 22 cm H2O. He improved and received pressure-support. Twelve days later a chest radiograph showed suspected air leaks, confirmed via computed tomogram (CT), which showed anterior pneumomediastinum. VT received over the previous 3 days had averaged 14 mL/kg predicted body weight. The patient was put back onto volume-controlled mode, and 2 days later there were no air leaks. In pressure-support ventilation, VT must be closely monitored to ensure lung-protective mechanical ventilation.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/55/6/770}, eprint = {https://rc.rcjournal.com/content/55/6/770.full.pdf}, journal = {Respiratory Care} }