Pneumomediastinum and Pneumothorax as Relevant Complications of Sub-Intensive Care of Patients with COVID-19: Description of a Case Series

Coppola, Maria Gabriella; Lugarà, Marina; Tamburrini, Stefania; Madonna, Pasquale; Panico, Claudio; Noschese, Giuseppe; Pone, Eduardo

doi:10.3390/medicina57090919

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Coppola et al reported their experience in six cases of pneumomediastinum and one case of pneumothorax during treatment in a sub-intensive area of the division of medicine [33]. In this series, four patients had pneumomediastinum and SCE following NIV.…”

Section: Discussionmentioning

confidence: 64%

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

Kajenthiran¹,

Tiwary²,

Lal³

et al. 2022

Cureus

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BackgroundDuring the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients developed pulmonary barotrauma either self-inflicted or ventilator-induced. In pulmonary barotrauma, air leaks into extra-alveolar tissue resulting in pneumomediastinum, subcutaneous emphysema, pneumothorax, and pneumoperitoneum. MethodsAfter obtaining institutional approval, we retrospectively reviewed data from March 1, 2021, to September 31, 2021. Being a retrospective study, informed consent was not applicable. Patient data were collected from the Al Shifa patient information portal, which is an electronic medical record system available to all hospitals in the Ministry of Health, Oman. After identifying patients with pulmonary barotrauma, the following details were recorded and entered into an Excel sheet (Microsoft Corporation, Albuquerque, New Mexico) and a database was created, which contained the following: age, sex, smoking history, comorbidities, type, location, mode of barotrauma, mode of ventilation, length of intensive care unit (ICU) stay, interventions performed, and overall outcome (survived/deceased). ResultsA total of 529 patients with COVID-19 pneumonia were admitted from March 2021 to September 2021 to the ICU. Twenty-eight patients developed barotrauma of variable severity and required interventions like the placement of intercostal drains. Out of 28, five patients developed spontaneous barotrauma, 14 patients had barotrauma after initiation of non-invasive ventilation, and nine patients had barotrauma as a result of invasive ventilation. The median number of days in the ICU was 19.5 (interquartile range: 12.5-26.5). Of the 28 patients, eight patients survived and were discharged from the hospital. ConclusionIn this single-center, retrospective study at a secondary care hospital in Oman, we described our experience with patients who suffered pulmonary barotrauma during their ICU admission. We have also presented the incidence of spontaneous versus ventilator-induced barotrauma, the length of stay of these patients, the outcomes in terms of survival or death, the need for tracheostomy, secondary infections, and interventions performed as indicated.

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Section: Discussionmentioning

confidence: 64%

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

Kajenthiran¹,

Tiwary²,

Lal³

et al. 2022

Cureus

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“…In rare cases, spontaneous PMS was associated with PTX [ 123 ]. The prevalence of these conditions increased during the second wave of the pandemic with the increasing use of oxygen through non-invasive ventilation and steroid therapy [ 118 , 121 , 122 , 123 , 124 , 125 , 126 ]. The high airway pressures delivered by these modalities of respiration probably supported the spontaneous rupture of fragile small airways infected by the virus ( Figure 17 and Figure 18 ).…”

Section: Lung Complicationsmentioning

confidence: 99%

A Pictorial Essay Describing the CT Imaging Features of COVID-19 Cases throughout the Pandemic with a Special Focus on Lung Manifestations and Extrapulmonary Vascular Abdominal Complications

Brogna

Bignardi

Megliola³

et al. 2023

Biomedicines

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With the Omicron wave, SARS-CoV-2 infections improved, with less lung involvement and few cases of severe manifestations. In this pictorial review, there is a summary of the pathogenesis with particular focus on the interaction of the immune system and gut and lung axis in both pulmonary and extrapulmonary manifestations of COVID-19 and the computed tomography (CT) imaging features of COVID-19 pneumonia from the beginning of the pandemic, describing the typical features of COVID-19 pneumonia following the Delta variant and the atypical features appearing during the Omicron wave. There is also an outline of the typical features of COVID-19 pneumonia in cases of breakthrough infection, including secondary lung complications such as acute respiratory distress disease (ARDS), pneumomediastinum, pneumothorax, and lung pulmonary thromboembolism, which were more frequent during the first waves of the pandemic. Finally, there is a description of vascular extrapulmonary complications, including both ischemic and hemorrhagic abdominal complications.

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“…The identification of several clinical conditions that represent risks of mortality for patients affected by COVID-19 [ 6 , 7 ], including the identification of several laboratory markers [ 8 , 9 ] that may play similar roles, attracted the attention of all workers in emergency departments. Furthermore, rare complications of treatments for COVID-19, such as spontaneous or ventilation-induced pneumothorax, pneumopericardium, or pneumopericardium, acquired great relevance during the outbreak [ 10 , 11 ]. Moreover, emergency departments adapted their activities to identify and manage the severe complications of vaccinations against SARS-CoV-2, such as vaccine-induced thrombocytopenia with thrombosis [ 12 ].…”

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confidence: 99%

Editorial for the Special Issue “Emergency Medicine and Emergency Room Medical Issues”

Micco

2023

Medicina

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Pneumomediastinum and Pneumothorax as Relevant Complications of Sub-Intensive Care of Patients with COVID-19: Description of a Case Series

Cited by 4 publications

References 14 publications

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

A Pictorial Essay Describing the CT Imaging Features of COVID-19 Cases throughout the Pandemic with a Special Focus on Lung Manifestations and Extrapulmonary Vascular Abdominal Complications

Editorial for the Special Issue “Emergency Medicine and Emergency Room Medical Issues”

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