Etiologies of alveolopleural fistula in mechanically ventilated patients

Common causes

Lung volume reduction surgery*

Pulmonary resection or biopsy

Spontaneous pneumothorax

Uncommon causes

Pulmonary infections (eg, necrotizing pneumonia)

Lung malignancies

Pleural drainage procedures (thoracentesis or chest tube insertion)

Barotrauma due to mechanical ventilation

Chest trauma including resuscitation (direct trauma or from overventilation)

Central line placement

Transbronchial biopsy

* Lung volume reduction surgery is responsible for almost half of cases

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