{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T01:00:11Z","timestamp":1759971611396,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T00:00:00Z","timestamp":1612656000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>We report the case of a patient who failed to meet tracheal extubation criteria due to low tidal volumes from suspected buffalo chest, which is a single pleural space physiology. This presentation followed the resection of a large pleural mass in a 59\u2010year\u2010old woman with a history of exercise\u2010induced asthma, hypertension and tumour\u2010related chronic respiratory failure. Creation of a pleuro\u2010pleural communication during the resection of this large, unilateral pleural mass led to bilateral pneumothoraces and contributed to patients inability to generate negative inspiratory force leading to failure to meet extubation criteria. Buffalo chest may be more prevalent than suspected and should be a differential diagnosis for low tidal volumes with spontaneous ventilation following thoracic surgery. It can be differentiated from other causes of decreased tidal volume using clinical examination, ultrasound and radiography. Bilateral chest tube placement can be considered to expedite pneumothorax resolution and tracheal extubation.<\/jats:p>","DOI":"10.1002\/anr3.12095","type":"journal-article","created":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T23:55:31Z","timestamp":1612742131000},"page":"32-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Failure to meet extubation criteria in the setting of suspected buffalo chest physiology"],"prefix":"10.1002","volume":"9","author":[{"given":"R. F.","family":"Chu","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. V.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. R.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy196"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2018.03.013"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2005.030981"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.184.2.1620848"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-3026.209202"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201509-1850IM"},{"key":"e_1_2_5_8_1","first-page":"745713","article-title":"Bilateral pneumothoraces following central venous cannulation","volume":"2009","author":"Pazos F","year":"2009","journal-title":"Journal of Medical Case Reports"},{"key":"e_1_2_5_9_1","first-page":"289","article-title":"Spontaneous bilateral pneumothorax in a patient with metastatic synovial sarcoma while under chemotherapy","volume":"1","author":"Ahmed MS","year":"2012","journal-title":"Translational Lung Cancer Research"},{"key":"e_1_2_5_10_1","first-page":"21","article-title":"Respiratory complications in the postanaesthesia care unit: a review of pathophysiological mechanisms","volume":"49","author":"Karcz M","year":"2013","journal-title":"Canadian Journal of Respiratory Therapy"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1263"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:11:37Z","timestamp":1759936297000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1002\/anr3.12095"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12095","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"type":"print","value":"2637-3726"},{"type":"electronic","value":"2637-3726"}],"subject":[],"published":{"date-parts":[[2021,1]]},"assertion":[{"value":"2020-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}