Fig. 1: Comparison of TD emtying rates in high and low PEEP and the cycle of lymphatic failure with imaging of lymphatic failure consequences.
From: Effect of positive pressure ventilation on lymphatic flow in pediatric patients
a US of the jugular (✻) and innominate vein (✻ ✻). b Contrast US image showing filling of the TD outlet with contrast agent (arrow) without spilling into the innominate vein. c With PEEP off spilling of contrast (arrowhead) and filling of the innominate vein is seen. d Signal intensity as a function of time at the distal TD (inserts) (In this plot a value of 0 is black). e Depiction of the vicious cycle initiated by increased ventilatory support in patients with lymphatic dysfunction with insert showing effusions and edema on MIP T2 weighted coronal image (top) and MIP coronal of IH-DCMRL (bottom) demonstrating leak into the duodenum consistent with PLE (arrowhead).
