Which of the following is NOT a complication of a flail chest segment?

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Flail chest segments disrupt normal chest wall mechanics, causing paradoxical movement and inefficient ventilation. This typically leads to shallow breathing and hypoventilation, which can cause atelectasis and a buildup of carbon dioxide. The broken ribs underlying the flail segment often injure lung tissue, producing pulmonary contusion and edema, which worsens gas exchange and increases dead space from ventilation–perfusion mismatch. Pulmonary contusion, increased dead space, and hypoventilation with atelectasis are all common, direct consequences of the injury.

Hyperventilation with respiratory alkalosis is not a direct complication of a flail chest. The usual course tends toward hypoventilation and possible respiratory acidosis rather than increased ventilation, so this pattern does not fit the typical pathophysiology of a flail chest segment.