Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series
Abstract Background Pneumothorax (PTX) and pneumomediastinum (PM) have been reported as potential complications in patients with coronavirus disease 2019 (COVID-19); however, their risk factors and etiology remain unknown. Herein, we investigated the clinical characteristics of mechanically ventilat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-023-04281-6 |
| _version_ | 1797363324783951872 |
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| author | Yohei Ide Nao Urushibata Wataru Takayama Kenichi Hondo Junichi Aiboshi Yasuhiro Otomo |
| author_facet | Yohei Ide Nao Urushibata Wataru Takayama Kenichi Hondo Junichi Aiboshi Yasuhiro Otomo |
| author_sort | Yohei Ide |
| collection | DOAJ |
| description | Abstract Background Pneumothorax (PTX) and pneumomediastinum (PM) have been reported as potential complications in patients with coronavirus disease 2019 (COVID-19); however, their risk factors and etiology remain unknown. Herein, we investigated the clinical characteristics of mechanically ventilated patients with COVID-19 with PTX or PM. Methods We examined patients with severe COVID-19 requiring mechanical ventilation who were admitted to the intensive care unit of a tertiary-level emergency medical center in Tokyo, Japan between April 1, 2020. and October 31, 2021. We collected and analyzed the clinical characteristics of the patients who presented with either PTX or PM during mechanical ventilation. Results During the study period, a total of 165 patients required mechanical ventilation, and 15 patients with PTX/PM during mechanical ventilation were selected. Three patients with obvious causes were excluded, and the remaining 12 patients were analyzed (7.3%). The mortality rate in these patients was as high as 50%, demonstrating the difficulty of treatment in the presence of PTX/PM. PTX/PM occurred 14.5 days after intubation. A peak pressure of > 30 cmH2O was only apparent in one patient, suggesting that high positive pressure ventilation may be less involved than mentioned in the literature. In addition, the inspiratory effort was not strong in our group of patients. (P0.1 was 2.1 cm H2O [1.0–3.8]). Conclusion Various factors are associated with the development of PTX/PM in patients on mechanical ventilation for COVID-19. We did not find a strong correlation between PTM/PM and barotrauma or strong inspiratory efforts, which have been identified as potential causes in previous studies. |
| first_indexed | 2024-03-08T16:19:47Z |
| format | Article |
| id | doaj.art-b88d43d1ff1e41dfb01c5eff483ab021 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-08T16:19:47Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-b88d43d1ff1e41dfb01c5eff483ab0212024-01-07T12:27:35ZengBMCJournal of Medical Case Reports1752-19472024-01-011811910.1186/s13256-023-04281-6Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case seriesYohei Ide0Nao Urushibata1Wataru Takayama2Kenichi Hondo3Junichi Aiboshi4Yasuhiro Otomo5Trauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineTrauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineTrauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineTrauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineTrauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineTrauma and Acute Critical Center, Tokyo Medical and Dental University Hospital of MedicineAbstract Background Pneumothorax (PTX) and pneumomediastinum (PM) have been reported as potential complications in patients with coronavirus disease 2019 (COVID-19); however, their risk factors and etiology remain unknown. Herein, we investigated the clinical characteristics of mechanically ventilated patients with COVID-19 with PTX or PM. Methods We examined patients with severe COVID-19 requiring mechanical ventilation who were admitted to the intensive care unit of a tertiary-level emergency medical center in Tokyo, Japan between April 1, 2020. and October 31, 2021. We collected and analyzed the clinical characteristics of the patients who presented with either PTX or PM during mechanical ventilation. Results During the study period, a total of 165 patients required mechanical ventilation, and 15 patients with PTX/PM during mechanical ventilation were selected. Three patients with obvious causes were excluded, and the remaining 12 patients were analyzed (7.3%). The mortality rate in these patients was as high as 50%, demonstrating the difficulty of treatment in the presence of PTX/PM. PTX/PM occurred 14.5 days after intubation. A peak pressure of > 30 cmH2O was only apparent in one patient, suggesting that high positive pressure ventilation may be less involved than mentioned in the literature. In addition, the inspiratory effort was not strong in our group of patients. (P0.1 was 2.1 cm H2O [1.0–3.8]). Conclusion Various factors are associated with the development of PTX/PM in patients on mechanical ventilation for COVID-19. We did not find a strong correlation between PTM/PM and barotrauma or strong inspiratory efforts, which have been identified as potential causes in previous studies.https://doi.org/10.1186/s13256-023-04281-6COVID-19Intensive care unitsIntubationPneumothoraxCase series |
| spellingShingle | Yohei Ide Nao Urushibata Wataru Takayama Kenichi Hondo Junichi Aiboshi Yasuhiro Otomo Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series Journal of Medical Case Reports COVID-19 Intensive care units Intubation Pneumothorax Case series |
| title | Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series |
| title_full | Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series |
| title_fullStr | Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series |
| title_full_unstemmed | Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series |
| title_short | Clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019: a case series |
| title_sort | clinical characteristics of pneumothorax and pneumomediastinum in mechanical ventilated patients with coronavirus disease 2019 a case series |
| topic | COVID-19 Intensive care units Intubation Pneumothorax Case series |
| url | https://doi.org/10.1186/s13256-023-04281-6 |
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