Tension pneumomediastinum in patients with COVID-19

Campisi, Alessio; Poletti, Venerino; Ciarrocchi, Angelo Paolo; Salvi, Maurizio; Stella, Franco

doi:10.1136/thoraxjnl-2020-215012

Cited by 20 publications

(38 citation statements)

References 2 publications

(1 reference statement)

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“…This may cause compression of large vessels, heart, and lungs leading to cardiovascular and respiratory compromise, which can be a threat to the patient's life. 2,4 COVID-19 infection attacks initially the respiratory system causing pneumonia. Complications include acute respiratory distress syndrome requiring invasive ventilation with higher or maximum ventilator settings.…”

Section: Discussionmentioning

confidence: 99%

“…The conservative management includes reducing airway pressures, allowing permissive hypercapnia and denitrogenation of the mediastinum air by increasing the percentage of oxygen supplementation. 2,3 Two of our patients were managed by insertion of the intercostal drain and three patients were managed conservatively. One patient required extracorporeal membrane oxygenation (ECMO) therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The literature search revealed one case report TPM and a case series titled "pneumomediastinum in COVID-19 patients". 2,3 We report another case series describing five patients of COVID-19 pneumonia who developed tension pneumomediastinum while being given invasive ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Tension Pneumomediastinum: A life-threatening condition in COVID-19 Patients

Shaheen

et al. 2021

Preprint

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Tension Pneumomediastinum: A life-threatening condition in COVID-19 Patients

Shaheen

et al. 2021

Preprint

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“…It can simultaneously cause subcutaneous gas accumulation in the suprasternal fossae, supraclavicular fossae, lateral chest wall, etc. Common etiologies include severe pneumonia such as COVID-19 pneumonia, asthma, excessive pressure from a ventilator, abdominal trauma or surgery, etc (1,2). Mild and moderate cases without obvious respiratory dysfunction or circulatory dysfunction can be cured by inhaling oxygen, analgesic, antibiotics and waiting for the body to absorb.…”

Section: Introductionmentioning

confidence: 99%

Inserting a Drainage Strip into the Pre-tracheal Space to Treat Tension Pneumomediastinum: A Case-control Study

Liu¹,

Song²,

Hong³

et al. 2021

Preprint

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Background: A Severe tension pneumomediastinum can result in respiratory and circulatory dysfunction. Common etiologies include severe pneumonia such as COVID-19 pneumonia, asthma, excessive pressure from a ventilator, etc. we describe a method for draining tension pneumomediastinum by inserting a drainage strip into the pre-tracheal space.Methods:Design: Case-control.Setting: Data from a medical institution in southern China.Participants: 30 patients with tension pneumomediastinum and comorbid type II respiratory failure.Interventions: 15 patients (surgery group) were treated with a drainage strip being inserted into the pre-tracheal space while other 15 patients (control group) were treated without drainage.Outcome measures: Arterial blood pO2 and pCO2 after 30 minutes and 12 hours of mechanical ventilation, total duration of mechanical ventilation, and chest radiography results after 12 hours of mechanical ventilation.Results: Chest radiography after 12 hours of mechanical ventilation showed that the pneumomediastinum basically disappeared in the surgery group but did not decrease significantly in the control group. The arterial blood pCO2 after 12 hours of mechanical ventilation and total duration of mechanical ventilation were significantly lower in the surgery group than in the control group (95% CI -3.31 to -1.36, p<0.001; 95% CI -5.56 to -2.84, p<0.001), while the arterial blood pO2 after 12 hours of mechanical ventilation was significantly higher in the surgery group than in the control group (95% CI 1.76 to 7.57, p=0.004). There were no significant intergroup differences in other variables. No recurrence occurred in either group during 7–14 days after discharge, and all patients recovered.Conclusions: Our method for draining tension pneumomediastinum improved respiratory function and shortened mechanical ventilation duration.Trial registration: ChiCTR2000039496Data sharing statement: Technical appendix, statistical code, and dataset available from the FigShare repository, https://doi.org/10.6084/m9.figshare.13487295.

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“…Finally, it is important to emphasize that none of the solutions studied allow implementing more complex ventilation modes, such as the air pressure release ventilation (APRV) mode, which is showing significant improvements for the stabilization of COVID-19 patients [26,27].…”

Section: Introductionmentioning

confidence: 99%

ResUHUrge: A Low Cost and Fully Functional Ventilator Indicated for Application in COVID-19 Patients

Vivas

Segovia

Bravo

et al. 2020

Sensors

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Although the cure for the SARS-CoV-2 virus (COVID-19) will come in the form of pharmaceutical solutions and/or a vaccine, one of the only ways to face it at present is to guarantee the best quality of health for patients, so that they can overcome the disease on their own. Therefore, and considering that COVID-19 generally causes damage to the respiratory system (in the form of lung infection), it is essential to ensure the best pulmonary ventilation for the patient. However, depending on the severity of the disease and the health condition of the patient, the situation can become critical when the patient has respiratory distress or becomes unable to breathe on his/her own. In that case, the ventilator becomes the lifeline of the patient. This device must keep patients stable until, on their own or with the help of medications, they manage to overcome the lung infection. However, with thousands or hundreds of thousands of infected patients, no country has enough ventilators. If this situation has become critical in the Global North, it has turned disastrous in developing countries, where ventilators are even more scarce. This article shows the race against time of a multidisciplinary research team at the University of Huelva, UHU, southwest of Spain, to develop an inexpensive, multifunctional, and easy-to-manufacture ventilator, which has been named ResUHUrge. The device meets all medical requirements and is developed with open-source hardware and software.

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Tension pneumomediastinum in patients with COVID-19

Cited by 20 publications

References 2 publications

Tension Pneumomediastinum: A life-threatening condition in COVID-19 Patients

Tension Pneumomediastinum: A life-threatening condition in COVID-19 Patients

Inserting a Drainage Strip into the Pre-tracheal Space to Treat Tension Pneumomediastinum: A Case-control Study

ResUHUrge: A Low Cost and Fully Functional Ventilator Indicated for Application in COVID-19 Patients

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