Ataturk Training and Research Hospital, Izmir Katip Celebi University, Department of Emergency Medicine, Izmir, Turkey.
Ataturk Training and Research Hospital, Izmir Katip Celebi University, Department of Emergency Medicine, Izmir, Turkey.
Braz J Anesthesiol. 2021 Jul-Aug;71(4):461-463. doi: 10.1016/j.bjane.2021.02.039. Epub 2021 Mar 22.
Noninvasive mechanical ventilation (NIMV) has a relevant role in the treatment of critically ill patients displaying severe dyspnea. Continuous positive airway pressure (CPAP), a method of NIMV, is also widely used in the management of acute heart failure, chronic obstructive pulmonary disease (COPD) exacerbation, and symptomatic sleep apnea. However, numerous traumatic complications of CPAP treatment in the face region, head, and thorax have been reported and may be related to the application of a continuous positive high pressure to the airway. Conversely, we have observed no complications due to CPAP-related increased intra-abdominal pressure. In this article, we describe a clinical case of a patient with an acute rectus sheath hematoma during CPAP treatment. This previously unreported complication demonstrates that CPAP should be carefully used in patients with exacerbated COPD with difficulty in expiration.
无创机械通气（NIMV）在治疗出现严重呼吸困难的危重症患者中具有重要作用。NIMV 中的一种方法，持续气道正压通气（CPAP）也广泛用于急性心力衰竭、慢性阻塞性肺疾病（COPD）加重和症状性睡眠呼吸暂停的治疗。然而，已经报道了 CPAP 治疗面部、头部和胸部区域的许多创伤性并发症，并且可能与对气道施加持续的高正压有关。相反，我们没有观察到由于 CPAP 相关的腹腔内压升高而引起的并发症。在本文中，我们描述了一例 CPAP 治疗期间发生急性腹直肌鞘血肿的患者的临床病例。这种以前未报道的并发症表明，对于 COPD 加重且呼气困难的患者，应谨慎使用 CPAP。
