large pneumothorax associated with mechanical ventilation in patients with chronic respiratory disease

Difficult intubation and mechanical ventilation are common causes of pneumothorax in critically ill patients. patients with chronic respiratory tract disease are at high risk for pneumothorax caused by positive-pressure mechanical ventilation. a timely diagnosis of pneumothorax is critical as it may evolve into tension pneumothorax. in this case report, we report a patient who has a decreased level of consciousness due to opioid overdose. in the emergency room, she underwent mechanical ventilation and became conscious after a naloxone injection. after extubation, she has extensive subcutaneous emphysema. however, her hemodynamic and respiratory status is normal. the chest ct scan showed a large pneumothorax caused by mechanical ventilation.