Pneumomediastinum and Subcutaneous Emphysema after Noninvasive Ventilation in a COVID-19 Patient

Vazzana, Natale; Ognibene, Silvia; Dipaola, Francesco

doi:10.5603/arm.a2020.0141

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…That may indicate that patients after COVID‐19 show increased lung frailty and therefore require careful observation to prevent respiratory deterioration 7 . Some studies show that even patients without invasive ventilation can develop pneumomediastinum and subcutaneous emphysema in the course of COVID‐19 pneumonia 8,9 …”

Section: Discussionmentioning

confidence: 99%

“…7 Some studies show that even patients without invasive ventilation can develop pneumomediastinum and subcutaneous emphysema in the course of COVID‐19 pneumonia. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

“…7 Some studies show that even patients without invasive ventilation can develop pneumomediastinum and subcutaneous emphysema in the course of COVID-19 pneumonia. 8,9 The rate of pulmonary embolus in the course of COVID-19 is higher than normally recorded in patients without COVID-19. Leonard-Lorant et al show that 30% of patients with COVID-19 infection were positive for acute pulmonary embolus.…”

Section: Case Reportmentioning

confidence: 91%

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Young convalescent COVID‐19 pneumonia with extensive pneumomediastinum emphysema: Case report

Jagosz

Guzik

Moczała

et al. 2022

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

“…7 Some studies show that even patients without invasive ventilation can develop pneumomediastinum and subcutaneous emphysema in the course of COVID‐19 pneumonia. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 91%

See 1 more Smart Citation

Young convalescent COVID‐19 pneumonia with extensive pneumomediastinum emphysema: Case report

Jagosz

Guzik

Moczała

et al. 2022

Clinical Case Reports

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“…Vazzana et al reported a case of an 80-year-old patient with severe pneumonia, who required assisted respiration with noninvasive mechanical ventilation. 57 Gorospe et al described a series of 4 cases of patients, with no history of pulmonary illnesses, hospitalised in clinics in Madrid, who were diagnosed with spontaneous pneumomediastinum. 58 Causes of pneumomediastinum are sought in the so-called Makclin effect, that is a sudden increase of pressure in the distal respiratory tract, which results in alveolar ruptures and secondary gas effusion into the pulmonary parenchyma, from which air can eventually reach the mediastinum.…”

Section: Pneumothoraxmentioning

confidence: 99%

Pulmonary complications due to COVID-19 – a literature review

Romaszko-Wojtowicz

Doboszyńska

2021

Pol. Ann. Med.

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Introduction: irst cases of a disease called coronavirus disease 2019 (COVID-19), caused by a novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of the coronavirus family, were detected in December 2019. The disease is manifested by a variety of symptoms and can run a different course: from oligosymptomatic or asymptomatic to the development of acute respiratory failure and even death. Aim: The aim of this paper is to provide critical analysis of the potential pulmonary complications after COVID-19 infection. Material and methods: We have provided the systematic literature review based on which we have discussed the pathophysiology of COVID-19, its outcomes, risk factors and pulmonary complications. Results and discussion: The organs that are most often affected by a SARS-CoV-2 infection are the lungs. An infection with this virus can lead to a severe respiratory tract illness, both in the acute phase and as a complication after a relatively mild case. There are numerous observations of patients convalescing from COVID-19 who suffer from the interstitial pulmonary disease with fibrosis. There are also reported cases of spontaneous pneumothorax after COVID-19. Conclusions: It should be borne in mind that other late complications may appear with time.

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“…This leads to air leakage into extra-alveolar tissue, which leads to pneumomediastinum, subcutaneous emphysema, pneumothorax, and pneumoperitoneum [1,2]. During the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), clinicians encountered many patients who developed barotrauma of varying types and severity during invasive/non-invasive ventilation, and even during spontaneous breathing in some cases [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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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Pneumomediastinum and Subcutaneous Emphysema after Noninvasive Ventilation in a COVID-19 Patient

Abstract: An 80-year-old man was admitted because of persistent fever and dyspnea [...]

Cited by 7 publications

References 5 publications

Young convalescent COVID‐19 pneumonia with extensive pneumomediastinum emphysema: Case report

Young convalescent COVID‐19 pneumonia with extensive pneumomediastinum emphysema: Case report

Pulmonary complications due to COVID-19 – a literature review

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

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