Hi Dave..
I think your refering to atelecatsis...a collapsing of tiny air sacs in the lungs ...not a collapsing of a lung itself ...atelectasis and pneumothoraxes are treated oppossitely...atelecatsis is treated with ventilation of positive pressure and an increase of Peep..where as a pnuemothorax or a partially collapsed lung is often treated with the negative pressure of a person breathing on their own ( as all vents, c-paps and bipaps are positive pressure) and by reducing peep..for full time or almost full-time ventilated PALS a chest tube is the only way to resolve a pneumothorax..as they can not breathe long enough to resolve them on their own.....
Of all the problems Gary has had since venting ..although atelectasis was once feared by docs when coming off the vent due to his low tidal volumes .it is easily seen on x-ray and has never been found..so he is still encouraged by his docs based on his last vent bypass parameters and chest x-rays to continue coming off...
Most PALS who are told they can come off a vent safely are given weaning trials ..to see how long they can bypass a vent..their stats are monitored contunously in a hospital setting ...docs typically order chest x-rays to insure atelectasis does not occur..before a recommendation is made for coming off the vent at home....I wouldn't however encourage PALS to come off a vent if your doc does not recommend it...Lisa