open access

Vol 88, No 5 (2020)
Clinical vignette
Published online: 2020-10-24
Submitted: 2020-04-18
Accepted: 2020-05-25
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Pneumomediastinum and subcutaneous emphysema after noninvasive ventilation in a COVID-19 patient

Natale Vazzana, Silvia Ognibene, Francesco Dipaola
DOI: 10.5603/ARM.a2020.0141
·
Pubmed: 33169823
·
Adv Respir Med 2020;88(5):466-467.

open access

Vol 88, No 5 (2020)
CLINICAL VIGNETTES
Published online: 2020-10-24
Submitted: 2020-04-18
Accepted: 2020-05-25

Abstract

Pneumomediastinum is an uncommon but well recognized complication of both invasive and non-invasive mechanical ventilation. Spontaneous pneumomediastinum has been observed in association with a variety of structural lung diseases including severe interstitial disorders. More recently it has been reported complicating the course of COVID-19 pneumonia. In the present report we describe a case of pneumomediastinum associated with subcutaneous emphysema in a patient with severe respiratory failure due to extensive interstitial pneumoniae correlated to SARS-CoV-2 infection which necessitated non-invasive ventilatory support. Prompt recognition is required during ventilatory support as it may promote its progression. Further data are needed in order to identify the mechanisms, frequency, risk factors and prognostic role of this rare complication of the clinical course of COVID-19.

Abstract

Pneumomediastinum is an uncommon but well recognized complication of both invasive and non-invasive mechanical ventilation. Spontaneous pneumomediastinum has been observed in association with a variety of structural lung diseases including severe interstitial disorders. More recently it has been reported complicating the course of COVID-19 pneumonia. In the present report we describe a case of pneumomediastinum associated with subcutaneous emphysema in a patient with severe respiratory failure due to extensive interstitial pneumoniae correlated to SARS-CoV-2 infection which necessitated non-invasive ventilatory support. Prompt recognition is required during ventilatory support as it may promote its progression. Further data are needed in order to identify the mechanisms, frequency, risk factors and prognostic role of this rare complication of the clinical course of COVID-19.

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Keywords

non-invasive ventilation; COVID-19; pneumomediastinum

About this article
Title

Pneumomediastinum and subcutaneous emphysema after noninvasive ventilation in a COVID-19 patient

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 5 (2020)

Article type

Clinical vignette

Pages

466-467

Published online

2020-10-24

DOI

10.5603/ARM.a2020.0141

Pubmed

33169823

Bibliographic record

Adv Respir Med 2020;88(5):466-467.

Keywords

non-invasive ventilation
COVID-19
pneumomediastinum

Authors

Natale Vazzana
Silvia Ognibene
Francesco Dipaola

References (5)
  1. Kouritas VK, Papagiannopoulos K, Lazaridis G, et al. Pneumomediastinum. J Thorac Dis. 2015; 7(Suppl 1): S44–S49.
  2. Iyer VN, Joshi AY, Ryu JH. Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients. Mayo Clin Proc. 2009; 84(5): 417–421.
  3. Kong N, Gao C, Xu MS, et al. COVID-19 with spontaneous pneumomediastinum. Lancet Infect Dis. 2020; 20(4): 510–3577.
  4. Chu CM, Leung YY, Hui JYH, et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J. 2004; 23(6): 802–804.
  5. Ruggeri P, Girbino G. Fatal pneumomediastinum associated with use of noninvasive mechanical ventilation. Respirol Case Rep. 2014; 2(4): 126–128.

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