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Hallam H. Ivey, MD; John Kattwinkel, MD; Bennett A. Alford, MD

Am J Dis Child. 1981;135(6):544-546.

Abstract
• 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 describe 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.

(Am J Dis Child 1981;135:544-546)

Author Affiliations
From the Departments of Pediatrics (Drs Ivey and Kattwinkel) and Radiology (Dr Alford), University of Virginia Medical Center, Charlottesville.

Footnotes
Reprint requests to Department of Pediatrics, University of Virginia Medical Center, Jefferson Park Avenue, Charlottesville, VA 22908 (Dr Ivey).

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