PMC9481296_01
The computed tomography (CT) scans of the patient (baseline). A baseline lung CT scan noted emphysema and pulmonary bulla in the left lung. The arrow in this figure points to the pulmonary bulla of lung.
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F1
A previous CT scan showed emphysema and a pulmonary bulla in the left lung (Figure 1).
The lung ultrasound and EIT monitoring (hypoxemia occurs). 1. Lung ultrasound imaging with a convex probe (5 MHz) showed the absence of gliding sign, confirmed by the Barcode sign in M-mode at the onset of hypoxemia. 2. Functional electrical impedance tomography (EIT) images of ventilation and perfusion distribution at the onset of hypoxemia. Low-ventilated regions are marked in dark blue and high-ventilated regions in white. Regions with high perfusion are marked in red and low perfusion in blue. A massive ventilation defect was found in the left lung in which perfusion was maintained, and perfusion and ventilation matched the image at the onset of hypoxemia. Regions with high ventilation and low perfusion (indicate dead space) are marked in light green; low ventilation and high perfusion regions (indicate intrapulmonary shunt) in light blue; good ventilation-perfusion matching in yellow.
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F2
A line pattern and lung sliding sign abolishment were found in the left lung (Figure 2), but there was no evidence of a lung point sign on emergency bedside ultrasound. A massive ventilation defect was found in the left lung, which had normal perfusion (Figure 2).
The results of the EIT assessment of the patient's lungs (post-treatment).
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F3
After enhancing sputum drainage by changing the patient's posture and chest physical therapy, the SpO2 improved, and the left lung ventilation recovered (Figure 3).
The chest X-ray of patient. Chest radiography did not show signs of pneumothorax. Functional EIT images of ventilation showed that the defect of the left lung had been restored after treatment.
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F4
The bedside chest X-ray excluded pneumothorax (Figure 4).