Recurrent unilateral lung hyperinflation as a manifestation of 'auto- PEEP'

Recurrent right lung hyperinflation developed in a 68-year-old man with chronic airflow obstruction. His past history was significant for tuberculosis in the left lung requiring a left upper lobe resection and residual bronchiectasis in the remaining lung. Recognition of the unilateral lung hyperinflation as being a manifestation of unintentional positive end- expiratory pressure (auto-PEEP) resulted in appropriate measures to reverse the process and prevent further complications such as barotrauma. Patients with chronic airflow obstruction and an inflammatory or fibrotic disease process primarily involving one lung are at risk for the development of this atypical presentation of auto-PEEP.