![]() Studies have shown that patients with underlying chronic lung diseases requiring invasive mechanical ventilation, such as interstitial lung disease, emphysema, and asthma, are more likely to develop barotrauma. High PEEP is essential to maintaining lung recruitment while preventing atelectrauma. Pulmonary barotrauma from mechanical ventilation usually occurs in the setting of high ventilatory pressures: peak inspiratory pressures (PIP), plateau pressure (Pplat), and positive end-expiratory pressure (PEEP). Pulmonary barotrauma leads to air leaks into the extra-alveolar tissue, causing subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumopericardium and pneumoperitoneum. Invasive mechanical ventilation can cause lung injury from pulmonary barotrauma and regional lung overdistension. SE was managed with blow-hole incisions and pneumothorax with chest tube. She developed extensive SE with pneumomediastinum and pneumothorax while on mechanical ventilation settings PEEP 13 cmH 2O and PIP 28 cmH 2O, Pplat 18 cmH 2O, and FiO2 90%. The second patient was a 58-year-old woman who was also mechanically ventilated due to hypoxemic respiratory failure from COVID-19, with PaO2/FiO2 of 81. He was managed with ‘blow-hole’ incisions, with subsequent clinical resolution of subcutaneous emphysema. ![]() He developed subcutaneous emphysema (SE) and pneumomediastinum on day 5 of mechanical ventilation at ventilatory settings of positive end-expiratory pressure (PEEP) ≤15 cmH 2O, plateau pressure (Pplat) ≤25 cmH 2O and pulmonary inspiratory pressure (PIP) ≤30 cmH 2O. His partial pressure of O2 to fraction of inspired oxygen ratio (PaO2/FiO2) was 156. The first patient was a 71-year-old man who was intubated and placed on mechanical ventilation due to hypoxemic respiratory failure from SARS-CoV-2 infection.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |