Tension Pneumomediastinum: A life-threatening condition in patients with COVID-19

Shaikh, Nissar; Ameri, Gamal Al; Shaheen, Muhsen; Abdaljawad, Wael; Prabhakaran, Sujith M; Wraidat, Mohammad Al; Mohmed, Ahmed S.; Khatib, Mohamad; Nashwan, Abdulqadir J.

doi:10.5339/qmj.2021.55

Cited by 12 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its prevalence, risk factors, and final outcome remain unclear. 13,14,[30][31][32][33][34][36][37][38][39] Our research contributes to understanding the combination of SP, SPM and COVID-19 in non-ventilated patients, and quantifying their associated risks for in-hospital mortality.…”

mentioning

confidence: 95%

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Marza¹,

Petrică²,

Lungeanu³

et al. 2022

IJGM

View full text Add to dashboard Cite

Background and Objectives: Spontaneous pneumothorax (SP) and spontaneous pneumomediastinum (SPM) have frequently been cited as complications associated with coronavirus disease 2019 (COVID-19) pneumonia, with especially poor prognosis in mechanically ventilated patients. The current literature is controversial regarding the potential risk factors for developing SP or SPM (SP-SPM) in non-ventilated COVID-19 patients. Our research addressed a twofold objective: (a) to investigate the characteristics of patients with SP-SPM (both with and without COVID-19) and compare them to patients with sole COVID-19; (b) to quantify the risk of in-hospital mortality associated with SP-SPM and COVID-19. Patients and Methods: A retrospective case-control study was conducted in the emergency departments (ED) of two tertiary hospitals in Timisoara, Romania, over one year (1st April 2020-31st March 2021; 64,845 records in total) and 70 cases of SP-SPM were identified (both SARS-CoV-2 positives and negatives). The control group comprised COVID-19 patients with no SP-SPM, included at a 2:1 ratio. Logistic regression was employed to quantify the in-hospital mortality risk associated with age, SP-SPM, and COVID-19. Results: SP-SPM and COVID-19 were connected with prolonged hospitalization, a higher percentage of intensive care admission, and a higher mortality. SP-SPM increased the odds of death by almost four times in patients of the same age, gender, smoking status, and SARS-CoV-2 infection: OR = 3.758, 95% CI (1.443-9.792). Each additional year of age added 9.4% to the mortality risk: OR = 1.094, 95% CI (1.054-1.135). Conclusion:ED physicians should acknowledge these potential risks when attending COVID-19 patients with SP-SPM.

show abstract

mentioning

confidence: 95%

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Marza¹,

Petrică²,

Lungeanu³

et al. 2022

IJGM

View full text Add to dashboard Cite

show abstract

“…Shaikh et al reported five patients with COVID-19 ARDS on mechanical ventilation on moderate positive end-expiratory pressure (PEEP) who developed tension pneumomediastinum [32]. In this series, two patients required chest drain to relieve the tension, one patient was managed with extracorporeal membrane oxygenation (ECMO) because of severe ARDS, and two patients died eventually.…”

Section: Discussionmentioning

confidence: 85%

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

Kajenthiran¹,

Tiwary²,

Lal³

et al. 2022

Cureus

View full text Add to dashboard Cite

BackgroundDuring the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients developed pulmonary barotrauma either self-inflicted or ventilator-induced. In pulmonary barotrauma, air leaks into extra-alveolar tissue resulting in pneumomediastinum, subcutaneous emphysema, pneumothorax, and pneumoperitoneum. MethodsAfter obtaining institutional approval, we retrospectively reviewed data from March 1, 2021, to September 31, 2021. Being a retrospective study, informed consent was not applicable. Patient data were collected from the Al Shifa patient information portal, which is an electronic medical record system available to all hospitals in the Ministry of Health, Oman. After identifying patients with pulmonary barotrauma, the following details were recorded and entered into an Excel sheet (Microsoft Corporation, Albuquerque, New Mexico) and a database was created, which contained the following: age, sex, smoking history, comorbidities, type, location, mode of barotrauma, mode of ventilation, length of intensive care unit (ICU) stay, interventions performed, and overall outcome (survived/deceased). ResultsA total of 529 patients with COVID-19 pneumonia were admitted from March 2021 to September 2021 to the ICU. Twenty-eight patients developed barotrauma of variable severity and required interventions like the placement of intercostal drains. Out of 28, five patients developed spontaneous barotrauma, 14 patients had barotrauma after initiation of non-invasive ventilation, and nine patients had barotrauma as a result of invasive ventilation. The median number of days in the ICU was 19.5 (interquartile range: 12.5-26.5). Of the 28 patients, eight patients survived and were discharged from the hospital. ConclusionIn this single-center, retrospective study at a secondary care hospital in Oman, we described our experience with patients who suffered pulmonary barotrauma during their ICU admission. We have also presented the incidence of spontaneous versus ventilator-induced barotrauma, the length of stay of these patients, the outcomes in terms of survival or death, the need for tracheostomy, secondary infections, and interventions performed as indicated.

show abstract

“…The chi-square [ 2 ] test and the Fisher exact test will be used to evaluate categorical data, if appropriate. The unpaired ‘ t ’ or Mann–Whitney U test will be used to compare continuous variables (quantitative data) between the 2 independent groups.…”

Section: Methods: Data Collection Management and Analysismentioning

confidence: 99%

“…Studies have revealed that COVID 19 virus utilizes the angiotensin converting enzyme, a protein expressed on the surface of many cells including respiratory mucosal epithelium, as a port of entry. [1][2][3] Angiotensin-converting enzyme-2 is normally secreted in upper and lower respiratory epithelial cells; thus, angiotensin-converting enzyme-2 stimulation in COVID-19 infection will significantly surge pro-inflammatory mediators and mucosal secretions, leading to dyspnea (breathlessness), cough, and throat pain. [4,5] This protein also acts as a pro-inflammatory mediator, which contributes to increased respiratory secretions in respiratory infections, and some of the other symptoms, predominantly, dyspnea, cough, and throat pain.…”

Section: Introductionmentioning

confidence: 99%

Nebulized fentanyl for respiratory symptoms in patients with COVID-19 (ventanyl trial)

Shaikh¹,

Khatib²,

Wraidat³

et al. 2022

Medicine

Self Cite

View full text Add to dashboard Cite

Patients with coronavirus disease (COVID-19) commonly experience distressing and challenging respiratory symptoms. Interventions such as oxygen therapy, oral opiates, and traditional nebulizers like ipratropium bromide and salbutamol are variable in their efficacy, and therapy responses in patients are difficult to predict. The purpose of this study is to investigate the efficacy of nebulized fentanyl citrate on dyspnea, cough, and throat pain in patients with COVID-19 and evaluate the safety with any potential adverse events. In COVID-19, about 59% of patients will exhibit cough, 35% generalized body ache and sore throat, and 31% dyspnea. Some methods such as nebulized lidocaine, magnesium sulfate, and systemic opioids have been used to manage the respiratory symptoms. It has been previously shown that fentanyl nebulizer has beneficial effect in improving shortness of breath in patients with chronic obstructive pulmonary disease. The proposed theory behind that was that fentanyl decreased the rate of spontaneous respiratory rate, diminished the brain stem chemoreceptor response to hypoxia and hypercarbia, in addition to exhibiting a modulating effect on the brain stem. Therefore, we hypothesize that nebulized fentanyl has superior effect in improving shortness of breath and relieving cough compared to normal saline, in addition to its advantageous throat pain relief, while exhibiting fewer side effects in patients with COVID 19 infection. Therefore, this phase-III, randomized, comparative, parallel assignment, single-blinded clinical trial aims at assessing the efficacy and safety of nebulized fentanyl to suppress cough, improve breathlessness, and relieve throat pain in patients with COVID-19.

show abstract

Tension Pneumomediastinum: A life-threatening condition in patients with COVID-19

Cited by 12 publications

References 0 publications

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman

Nebulized fentanyl for respiratory symptoms in patients with COVID-19 (ventanyl trial)

Contact Info

Product

Resources

About