A curious case of idiopathic subcutaneous emphysema

Kamboj, Mayanka; Bhatti, Vikrampal; Koratala, Abhilash

doi:10.1093/omcr/omy004

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…Invasive mechanical ventilation may cause lung injury due to pulmonary barotrauma 1 . Pulmonary barotrauma causes air leaks into the extra-alveolar tissue, causing subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumopericardium, and pneumoperitoneum 2,3 . Pulmonary barotrauma from mechanical ventilation usually occurs at high ventilation pressures (peak inspiratory pressures, plateau pressure, and positive end-expiratory pressure (PEEP)).…”

Section: Introductionmentioning

confidence: 99%

The Effect of COVID-19 Vaccines on Pneumothorax in Geriatric Patients Hospitalized in Intensive Care Unit Due to COVID-1

Gokce

2022

ACC

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In our study, we examined the effect of COVID-19 vaccination on the incidence of pneumothorax in intensive care patients over age 65. COVID-19 intensive care patients that presented to our department between April 2020 and May 2021 during the COVID-19 pandemic were evaluated retrospectively. Patients were divided into two main groups, i.e., before and after the vaccination period. Patients were evaluated retrospectively for the following parameters: gender, age, side of pneumothorax, mortality, discharge, comorbidity, and additional pleural complications. The total number of patients was 87, i.e., 66 patients before vaccination and 21 patients after vaccination. When patients in the pre-and post-vaccination period were compared, there was a significant difference in the incidence of pneumothorax between the two groups (p<0.05). Pneumothorax was less common after vaccination. When patients with pneumothorax and tube thoracostomy were evaluated according to pre-and post-vaccination mortality, mortality was significantly higher (89%) in the pre-vaccination period (p<0.05). We consider that COVID-19 vaccines used in patients aged over 65 reduced the incidence of pleural complications, especially pneumothorax. We think that mortality due to pneumothorax in patients over 65 years of age was lower during the vaccination period. In addition, we think that bilateral pneumothorax was more common in the non-vaccinated period. As a result, we think that life-threatening pneumothorax and similar complications could be reduced by increasing the number of vaccines made in the COVID-19 pandemic and spreading it around the world.

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Section: Introductionmentioning

confidence: 99%

The Effect of COVID-19 Vaccines on Pneumothorax in Geriatric Patients Hospitalized in Intensive Care Unit Due to COVID-1

Gokce

2022

ACC

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“…Invasive mechanical ventilation can cause lung injury from pulmonary barotrauma and regional lung overdistension [ 1 ]. Pulmonary barotrauma leads to air leaks into the extra-alveolar tissue, causing subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumopericardium and pneumoperitoneum [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Barotrauma Resulting from Mechanical Ventilation in 2 Patients with a Diagnosis of COVID-19 Pneumonia

et al. 2021

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Case series Patients: Male, 71-year-old • Female, 58-year-old Final Diagnosis: Pulmonary barotrauma Symptoms: Pneumomediastinum Medication: — Clinical Procedure: Chest tube Specialty: Critical Care Medicine Objective: Unusual clinical course Background: Invasive mechanical ventilation can cause pulmonary barotrauma due to elevated transpulmonary pressure and alveolar rupture. A significant proportion of COVID-19 patients with acute respiratory distress syndrome (ARDS) will require mechanical ventilation. We present 2 interesting cases that demonstrate the possibility of COVID-19-associated ARDS manifesting with pulmonary barotrauma at acceptable ventilatory pressures. Case Reports: The first patient was a 71-year-old man who was intubated and placed on mechanical ventilation due to hypoxemic respiratory failure from SARS-CoV-2 infection. His partial pressure of O2 to fraction of inspired oxygen ratio (PaO2/FiO2) was 156. He developed subcutaneous emphysema (SE) and pneumomediastinum on day 5 of mechanical ventilation at ventilatory settings of positive end-expiratory pressure (PEEP) ≤15 cmH 2 O, plateau pressure (Pplat) ≤25 cmH 2 O and pulmonary inspiratory pressure (PIP) ≤30 cmH 2 O. He was managed with ‘blow-hole’ incisions, with subsequent clinical resolution of subcutaneous emphysema. The second patient was a 58-year-old woman who was also mechanically ventilated due to hypoxemic respiratory failure from COVID-19, with PaO2/FiO2 of 81. She developed extensive SE with pneumomediastinum and pneumothorax while on mechanical ventilation settings PEEP 13 cmH 2 O and PIP 28 cmH 2 O, Pplat 18 cmH 2 O, and FiO2 90%. SE was managed with blow-hole incisions and pneumothorax with chest tube. Conclusions: Clinicians should be aware of pulmonary barotrauma as a possible complication of COVID-19 pulmonary disease, even at low ventilatory pressures.

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“…Hence, the term 'subcutaneous emphysema' refers a collection/infiltration of air in a limited space in the body [1]. In other words, it is swelling of the tissues under the skin because of air tracking along tissue planes [2]. Several risk factors can contribute to the formation of subcutaneous emphysema, including but are not limited to surgical or endoscopic operations, trauma, pneumothorax, infections and spontaneous [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…In other words, it is swelling of the tissues under the skin because of air tracking along tissue planes [2]. Several risk factors can contribute to the formation of subcutaneous emphysema, including but are not limited to surgical or endoscopic operations, trauma, pneumothorax, infections and spontaneous [2,3]. Injury to the thoracic cavity, sinus cavities, facial bones, barotrauma, bowel perforation or pulmonary blebs are some common causes [3].…”

Section: Introductionmentioning

confidence: 99%

“…In terms of management, subcutaneous emphysema will usually resolve conservatively without serious complications, however, concerted effort with careful observation should be made [6]. Severe cases of subcutaneous emphysema may require surgical interventions such as subcutaneous incisions, needles, drains or even mediastinotomy and this is determined mainly by the amount and sites of trapped air, presenting symptoms, haemodynamic instability and possible complications accordingly (compartment syndrome, for example) [2,6]. Herein, we will present a case of extensive subcutaneous emphysema that needed a surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

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A Young Healthy Female with Idiopathic Extensive Subcutaneous Emphysema Occurring in Neck, Mediastinum, Left Arm, Peritoneal and Retroperitoneal Spaces: A Case Report

Albader¹,

Almutairi²

2021

JSRP

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A curious case of idiopathic subcutaneous emphysema

Cited by 3 publications

References 2 publications

The Effect of COVID-19 Vaccines on Pneumothorax in Geriatric Patients Hospitalized in Intensive Care Unit Due to COVID-1

The Effect of COVID-19 Vaccines on Pneumothorax in Geriatric Patients Hospitalized in Intensive Care Unit Due to COVID-1

Pulmonary Barotrauma Resulting from Mechanical Ventilation in 2 Patients with a Diagnosis of COVID-19 Pneumonia

A Young Healthy Female with Idiopathic Extensive Subcutaneous Emphysema Occurring in Neck, Mediastinum, Left Arm, Peritoneal and Retroperitoneal Spaces: A Case Report

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