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COVID-19 所致弥漫性肺泡损伤患者的纵隔气肿。

Pneumomediastinum in a patient with COVID-19 due to diffuse alveolar damage.

机构信息

Pulmonology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands.

Radiology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands.

出版信息

BMJ Case Rep. 2021 May 11;14(5):e242527. doi: 10.1136/bcr-2021-242527.

DOI:10.1136/bcr-2021-242527
PMID:33975848
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8117474/
Abstract

A 74-year-old man with COVID-19 was admitted and experienced progressive dyspnoea while receiving supplemental oxygen via high-flow nasal cannula (HFNC). A CT of the thorax showed a pneumomediastinum. The HFNC was temporally interrupted, since it was uncertain whether the positive end-expiratory pressure of the HFNC could be the cause of the pneumomediastinum. After restart of the HFNC, there was no increase of symptoms. We suggest that the pneumomediastinum was the result of COVID-19-related alveolar damage, and not due to the use of HFNC. This observation is relevant since HFNC is often used in the treatment of severe COVID-19 pneumonia.

摘要

一名 74 岁男性感染 COVID-19，在接受高流量鼻导管（HFNC）吸氧时出现进行性呼吸困难。胸部 CT 显示纵隔气肿。HFNC 暂时中断，因为不确定 HFNC 的呼气末正压是否是纵隔气肿的原因。重新开始使用 HFNC 后，症状没有加重。我们认为纵隔气肿是 COVID-19 相关肺泡损伤的结果，而不是由于使用 HFNC 引起的。这一观察结果很重要，因为 HFNC 常用于治疗严重 COVID-19 肺炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/e37b16f4c5b7/bcr-2021-242527f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/b7074a8d9d88/bcr-2021-242527f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/5176e2db6b41/bcr-2021-242527f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/ebc6779392fe/bcr-2021-242527f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/4fb402c7ed2c/bcr-2021-242527f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/e37b16f4c5b7/bcr-2021-242527f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/b7074a8d9d88/bcr-2021-242527f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/5176e2db6b41/bcr-2021-242527f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/ebc6779392fe/bcr-2021-242527f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/4fb402c7ed2c/bcr-2021-242527f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cb6/8117474/e37b16f4c5b7/bcr-2021-242527f05.jpg

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Eur Respir J. 2020 Nov 19;56(5). doi: 10.1183/13993003.02697-2020. Print 2020 Nov.
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Spontaneous Pneumomediastinum in Patients With COVID-19: A Case Series of Four Patients.新型冠状病毒肺炎患者的自发性纵隔气肿：4例病例系列
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A case of subcutaneous emphysema/mediastinal emphysema during the use of humidified high-flow nasal cannula.
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