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与无创机械通气使用相关的致命性纵隔气肿

Fatal pneumomediastinum associated with use of noninvasive mechanical ventilation.

作者信息

Ruggeri Paolo, Girbino Giuseppe

机构信息

Department of Experimental Medicine and Surgery with Odontostomatology, Respiratory Unit, Policlinico Universitario "G.Martino" di Messina Messina, Italy.

出版信息

Respirol Case Rep. 2014 Dec;2(4):126-8. doi: 10.1002/rcr2.73. Epub 2014 Sep 14.

DOI:10.1002/rcr2.73
PMID:25530859
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4263491/
Abstract

We present a case of fatal pneumomediastinum in a patient with acute respiratory failure caused by acute exacerbated chronic obstructive pulmonary disease (AECOPD) and interstitial lung disease (ILD) precipitated by noninvasive mechanical ventilation (NIMV). To our knowledge, this is the first case reported in the literature. NIMV is very useful to treat acute respiratory failure due to AECOPD improving survival and avoiding endotracheal intubation. Use of NIMV in end stage ILD is not standardized and efficacy is to be proven. No data are reported to manage patient with concomitant COPD and ILD. Pathophysiological mechanisms underlying this fatal complication are explained and suggestions to treat this subgroup of patients discussed.

摘要

我们报告了一例因无创机械通气（NIMV）诱发的急性加重慢性阻塞性肺疾病（AECOPD）和间质性肺疾病（ILD）导致急性呼吸衰竭患者发生致命性纵隔气肿的病例。据我们所知，这是文献中报道的首例此类病例。NIMV对于治疗因AECOPD导致的急性呼吸衰竭非常有用，可提高生存率并避免气管插管。在终末期ILD中使用NIMV尚未标准化，其疗效有待证实。目前尚无关于合并COPD和ILD患者管理的数据报告。本文解释了这一致命并发症的病理生理机制，并讨论了治疗该亚组患者的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a2/4263491/936316f75f29/rcr20002-0126-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a2/4263491/9f59477ff95e/rcr20002-0126-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a2/4263491/936316f75f29/rcr20002-0126-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a2/4263491/9f59477ff95e/rcr20002-0126-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7a2/4263491/936316f75f29/rcr20002-0126-f2.jpg

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