A 51-Year-Old Man Develops Acute Respiratory Distress Syndrome While Hospitalized

A 51-year-old man develops acute respiratory distress syndrome while hospitalized for acute pancreatitis.  On his third day in the intensive care unit, the patient is sedated, intubated, and ventilated with a positive end-expiratory pressure of 15 cm water and fraction of inspired oxygen of 0.6 (60%) .  His pulse acutely increases from 100 to 140/min, systolic blood pressure drops from 120 to 90 mm Hg, and central venous pressure increases from 10 to 15 cm water.  On chest auscultation, breath sounds are absent on the left side.  Which of the following is the most likely explanation for the sudden deterioration of this patient?

A) Cardiac tamponade
B) Endotracheal tube shift into the right main bronchus
C) Mucous plugging and atelectasis
D) Pneumothorax
E) Pulmonary embolism

Correct Answer:

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