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重症新型冠状病毒肺炎患者无创呼吸支持后发生纵隔气肿和气胸

Pneumomediastinum and Pneumothorax Following Non-invasive Respiratory Support in Patients With Severe COVID-19 Disease.

作者信息

Gutierrez-Ariza Juan Camilo, Rodriguez Yanez Tómas, Martinez-Ávila Maria Cristina, Almanza Hurtado Amilkar, Dueñas-Castell Carmelo

机构信息

Critical Care Medicine, Clinica La Ermita, Cartagena, COL.

Critical Care Medicine, Universidad De Cartagena, Cartagena, COL.

出版信息

Cureus. 2021 Oct 15;13(10):e18796. doi: 10.7759/cureus.18796. eCollection 2021 Oct.

Abstract

The coronavirus disease-2019 (COVID-19) pandemic led to an increased number of patients with pneumothorax and pneumomediastinum owing to complications attributed to viral pneumonia regardless of the use of mechanical invasive ventilation and the elapsed time of infection. The pathophysiology remains unknown. However, the Macklin effect is shown as the most plausible mechanism along with possible barotrauma secondary to a high-flow nasal cannula and noninvasive mechanical ventilation. We present two cases of patients who developed pneumomediastinum and tension pneumothorax. One of the patients was studied during infection and the other after recovery. Both received appropriate and timely treatments with successful outcomes. It is important to be aware of these potentially fatal complications as early management can reduce the associated morbidity and mortality.

摘要

2019冠状病毒病(COVID-19)大流行导致气胸和纵隔气肿患者数量增加,这是由病毒性肺炎的并发症引起的,无论是否使用有创机械通气以及感染持续时间长短。其病理生理学仍不清楚。然而,麦克林效应被认为是最合理的机制,同时高流量鼻导管和无创机械通气可能导致气压伤。我们报告两例发生纵隔气肿和张力性气胸的患者。其中一例患者在感染期间接受研究,另一例在康复后接受研究。两名患者均接受了适当及时的治疗,结果成功。认识到这些潜在的致命并发症很重要,因为早期管理可以降低相关的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9deb/8590743/52832a6ff95b/cureus-0013-00000018796-i01.jpg

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