A 13 yo adolescent girl with history of myotonic dystrophy presents with a 2 day history of cough, nasal congestion, and several episodes of non-bloody nonbilious emesis presents in respiratory distress.
On examination her oxygen saturation is 80%, she is sleepy and minimally responsive to painful stimuli. She is intubated with fentanyl, midazolam, and rocuronium.
The post-intubation chest x-ray is shown below.
Image courtesy of Ashley Keilman, MD
What is the most likely cause of the chest x-ray findings.
This question appears in Med-Challenger Pediatric Emergency Medicine 3rd Edition Exam Review with CME
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