66 year old, 16 days after COVID-19 on mechanical ventilation with FiO2 of 65% and PEEP of 12 who developed hypoxemia, hypotension, and increased ventilator peak pressures.
An inspiratory hold revealed an increase in the plateau pressure indicating a low lung or chest wall compliance. Breath sounds were decreased on the right side.
Stat chest X-ray revealed tension pneumothorax on the right side.
Chest tube was emergently inserted on the right side with re-exapnsion of the lung.
Condition of the patient improved with an improvement in her hemodynamic profile and a decrease in her inspiratory plateau pressure.