Hazariwala Vikisha, Hadid Hind, Kirsch Denise, Big Cecilia
Beaumont Hospital, Dearborn, MI, USA.
J Cardiothorac Surg. 2020 Oct 7;15(1):301. doi: 10.1186/s13019-020-01308-7.
Spontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia. The objective of this case presentation is to highlight an important complication and to explore potential predisposing risk factors and possible underlying pathophysiology of this phenomenon.
We present two patients with COVID-19 pneumonia complicated by spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema without positive pressure ventilation. Both patients had multiple comorbidities, received a combination of antibiotics, steroids and supportive oxygen therapy, and underwent routine laboratory workup. Both patients then developed spontaneous pneumomediastinum and ultimately required intubation and mechanical ventilation, which proved to be challenging to manage.
Spontaneous pneumomediastinum is a serious complication of COVID-19 pneumonia, of which clinicians should be aware. Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia.
与机械通气无关的自发性纵隔气肿是新型冠状病毒肺炎（COVID-19肺炎）一种新描述的并发症。本病例报告的目的是强调一种重要并发症，并探讨该现象潜在的诱发风险因素和可能的潜在病理生理学机制。
我们报告了两名COVID-19肺炎患者，他们并发自发性纵隔气肿、心包积气、气胸和皮下气肿，未接受正压通气。两名患者均有多种合并症，接受了抗生素、类固醇和支持性氧疗的联合治疗，并进行了常规实验室检查。随后，两名患者均发生了自发性纵隔气肿，最终需要插管和机械通气，事实证明这在管理上具有挑战性。
自发性纵隔气肿是COVID-19肺炎的一种严重并发症，临床医生应予以关注。需要进一步研究以确定COVID-19肺炎中自发性纵隔气肿发生的风险因素和预测其发生的实验室数据。
