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Related to intrapleural pressure: alveolar pressure, transmural pressure, Transpulmonary pressure
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Spontaneous pneumomediastinum typically occurs when there is a significant increase in pulmonary volume followed by a dramatic increase in intrapleural pressure as seen with sneezing, coughing, vomiting, and Valsalva maneuvers.
Patients should also know that the negative intrapleural pressure gradient that is generated during deep breathing or paroxysms of coughing might cause a vacuum effect, which can also facilitate the aspiration of an object held loosely around the stoma.
Despite the focus of the recent literature on airway pressure and flow based indicators (such as plateau pressure, mean airway pressure, stress index, inflection/deflection points and tidal compliance) for setting tidal volume and PEEP, it is hazardous to rely on any of these without knowing the intrapleural pressure and absolute volume of the lungs.