What is a contraindication for positive pressure ventilation?

Positive pressure ventilation involves delivering air into the lungs through a mechanical ventilatory device, which increases airway pressure to assist or take over the work of breathing. In the case of a recent pneumonectomy, the removal of a lung significantly alters the patient's respiratory mechanics and capacity. Positive pressure ventilation in such cases can lead to complications, such as shifting the mediastinum or causing barotrauma in the remaining lung, which can result in further respiratory distress or inadequate gas exchange.

While patients with severe asthma attacks, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) may face challenges in breathing, positive pressure ventilation is often used in their management to facilitate adequate ventilation and oxygenation under controlled conditions. In contrast, the unique anatomical and physiological changes following a pneumonectomy require careful consideration, making positive pressure ventilation a contraindication due to the risks associated with positive pressures affecting the remaining lung.