A 15-year-old girl with a spontaneous pneumothorax presented with a cough and worsening chest pain. Re-expansion pulmonary oedema developed 20 minutes after chest tube drainage. Immediate resuscitation was started for hypotension and bradycardia. Hypoxaemia was managed by BiPAP mask ventilation; respiratory failure and pulmonary oedema showed dramatic improvement 8 hours later.
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