Choo-Kang Lee R, Ogunlesi Folasade O, McGrath-Morrow Sharon A, Crawford Thomas O, Marcus Carole L
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Pediatr Pulmonol. 2002 Jul;34(1):73-8. doi: 10.1002/ppul.10098.
Although a common complication of mechanical ventilation in acute respiratory failure, spontaneous pneumothorax has been rarely reported among patients on chronic, intermittent, noninvasive positive pressure support. We report the first case of recurrent pneumothoraces associated with nocturnal bilevel positive airway pressure ventilation via a nasal mask.A 26-year old man with chronic respiratory failure secondary to an unclassified neuromuscular condition suffered four separate episodes of spontaneous pneumothorax over a 12-month period. Two episodes occurred while he was asleep on bilevel positive airway pressure support. He was found to have numerous subpleural blebs, and we propose a mechanism for their development. Following open pleurodesis and blebectomy, the patient has not had another pneumothorax. Given the increasing utilization of chronic nocturnal bilevel positive airway pressure ventilation, we suggest that healthcare providers and patients be made aware of this potentially life-threatening complication.
虽然自发性气胸是急性呼吸衰竭机械通气的常见并发症，但在接受慢性、间歇性、无创正压支持的患者中鲜有报道。我们报告首例与经鼻面罩夜间双水平气道正压通气相关的复发性气胸病例。一名26岁男性因未分类的神经肌肉疾病继发慢性呼吸衰竭，在12个月内发生了4次自发性气胸。其中两次发作是在他接受双水平气道正压支持睡眠时发生的。发现他有大量胸膜下肺大疱，我们提出了其形成机制。在接受开放性胸膜固定术和肺大疱切除术之后，该患者未再发生气胸。鉴于慢性夜间双水平气道正压通气的使用日益增加，我们建议医疗服务提供者和患者了解这种潜在的危及生命的并发症。
