Causes of no Lung Sliding - Differential Diagnosis
• Massive atelectasis - If the lung is that compressed, it isn't being ventilated. A non-ventilated lung won't slide.
• Main-stem intubation in a paralyzed patient - If only one lung is being ventilated, the other lung won't be moving, and therefore will not demonstrate lung sliding.
• Inflammatory adhesions (ARDS, pneumonia, etc) and fibrosis - If the visceral pleura can't move relative to the parietal pleura due to it being stuck, you don't see lung sliding.
• Phrenic nerve palsy - If the diaphragm isn't moving the lungs and the pleural line are going to have a really hard time moving. If it isn't moving you won't see lung sliding
• Contusions - Unclear, but probably due to inflammation causing the visceral and parietal pleura to get stuck to each other
• Cardiopulmonary arrest (without an airway) and apnea - If the patient isn't breathing, the lung isn't moving. If the lung isn't moving, there won't be lung sliding.
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