Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus

González-García, Lara; Rey, Corsino; Medina, Alberto; Mayordomo-Colunga, Juan

doi:10.4103/0972-5229.180047

Cited by 4 publications

(8 citation statements)

References 11 publications

(10 reference statements)

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“…Despite frequent use of NIV for acute respiratory failure due to varied causes, SE is very seldom reported with its use in literature [ 12 , 13 ] before COVID-19. It is therefore postulated that COVID-19 patients with extensive lung damage might have increased respiratory drive with persistent strong spontaneous inspiratory efforts causing self-inflicted lung injury as postulated by Gattinoni [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan

et al. 2021

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Since December 2019, the clinical symptoms of coronavirus disease 2019 (COVID-19) and its complications are evolving. As the number of COVID patients requiring positive pressure ventilation is increasing, so is the incidence of subcutaneous emphysema (SE). We report 10 patients of COVID-19, with SE and pneumomediastinum. The mean age of the patients was 59 ± 8 years (range, 23–75). Majority of them were men (80%), and common symptoms were dyspnoea (100%), fever (80%) and cough (80%). None of them had any underlying lung disorder. All patients had acute respiratory distress syndrome on admission, with a median PaO2/FiO2 ratio of 122.5. Eight out of ten patients had spontaneous pneumomediastinum on their initial chest x-ray in the emergency department. The median duration of assisted ventilation before the development of SE was 5.5 days (interquartile range, 5–10 days). The highest positive end-expiratory pressure (PEEP) was 10 cmH2O for patients recieving invasive mechanical ventilation, while 8 cmH2O was the average PEEP in patients who had developed subcutaneous emphysema on non-invasive ventilation. All patients received corticosteroids while six also received tocilizumab, and seven received convalescent plasma therapy, respectively. Seven patients died during their hospital stay. All patients either survivor or non-survivor had prolonged hospital stay with an average of 14 days (range 8−25 days). Our findings suggest that it is lung damage secondary to inflammatory response due to COVID-19 triggered by the use of positive pressure ventilation which resulted in this complication. We conclude that the development of spontaneous pneumomediastinum and SE whenever present, is associated with poor outcome in critically ill COVID-19 ARDS patients.

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Section: Discussionmentioning

confidence: 99%

Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan

et al. 2021

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“… 13 Gonzalez and colleagues (2016) reported a case of NIV induced exacerbation of air leak resulting in intense cervical subcutaneous emphysema and pneumomediastinum in a patient with asthma. 2 SE can occur without pneumothorax or pneumomediastinum in patients with cavitary pulmonary tuberculosis. 14 Singh and colleagues reported a case of spontaneous SE and pneumomediastinum in a patient with H1N1 pneumonia.…”

Section: Discussionmentioning

confidence: 98%

“…Cases of NIV induced pneumomediastinum and subcutaneous emphysema (SE) have been reported in patients with chronic obstructive pulmonary disease (COPD) and asthma. 2 Recently a few authors have also reported this in Covid-19 patients. 3 , 4 In this communication we report an occurrence of bilateral subcutaneous emphysema in a patient of COVID-19 pneumonia without pneumothorax and pneumomediastinum having no previous history of respiratory disease.…”

Section: Introductionmentioning

confidence: 85%

Non-invasive ventilation (NIV) induced bilateral subcutaneous emphysema in SARS COV-2 patient: A rare occurrence

Routaray

Prasad

Rajagopalan

2021

Trends in Anaesthesia and Critical Care

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“…1 The prevalence of ES varies from 0.43% to 2.34%. [2][3][4] A study conducted by Aghajanzadeh et al over a period of 10 years revealed that the mean age of those diagnosed with ES ranges from 25 to 53 years, with males accounting for 71% of the patient population.…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis and Minimally Invasive Management of Subcutaneous Emphysema: A Narrative Literature Review

Syafitra,

Sri Indah Indriani

2023

Bioscmed

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Subcutaneous emphysema is the result of air infiltrating the subcutaneous and soft tissues. The prevalence of subcutaneous emphysema varies between 0.43% and 2.34%. Subcutaneous emphysema typically results in mild symptoms, poses no significant risk, and does not necessitate specific medical intervention. Pathologies affecting underlying tissues can exhibit greater severity and pose a risk to life. Subcutaneous emphysema is a challenge in terms of how to handle it. The treatment should initiate a focused endeavor to determine the underlying etiology of subcutaneous air dissection. This literature review focuses on subcutaneous emphysema, specifically exploring its pathogenesis and therapy strategies for people with this condition.

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Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus

Cited by 4 publications

References 11 publications

Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan

Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan

Non-invasive ventilation (NIV) induced bilateral subcutaneous emphysema in SARS COV-2 patient: A rare occurrence

Pathogenesis and Minimally Invasive Management of Subcutaneous Emphysema: A Narrative Literature Review

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