Pneumothorax in critically COVID-19 patients with mechanical ventilation
Coronavirus disease 2019 (COVID-19) is a public health emergency caused by SARS-CoV-2. A few studies reported pneumothorax in patients with COVID-19. Pneumothorax is associated with an increased morbidity and mortality. Hence, it should be considered during the treatment and follow-up of patients with COVID-19. Herein, we reported four cases of pneumothorax in critical COVID-19 patients hospitalized in the ICU and treated with a mechanical ventilation. All patients were diagnosed with COVID-19, type 1 respiratory failure, and acute respiratory distress syndrome. All patients developed pneumothorax during mechanical ventilation, although the ventilator settings were set to lung-protective strategy.
Sun J, He WT, Wang L, Lai A, Ji X, Zhai X, et al. COVID-19: epidemiology, evolution, and cross-disciplinary perspectives. Trends Mol Med. 2020;26(5):483−95. https://doi.org/10.1016/j.molmed.2020.02.008
Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J Hear Lung Transplant. 2020;39(5):405−7. https://doi.org/10.1016/j.healun.2020.03.012
Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225−8. https://doi.org/10.1016/S0140-6736(20)30627-9
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. 2020;323(16):1574−81. https://doi.org/10.1001/jama.2020.5394
Ucpinar BA, Sahin C, Yanc U. Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: case report. J Infect Public Health. 2020;13(6):887−9. https://doi.org/10.1016/j.jiph.2020.05.012
Aiolfi A, Biraghi T, Montisci A, Bonitta G, Micheletto G, Donatelli F, et al. Management of persistent pneumothorax with thoracoscopy and blebs resection in COVID-19 patients. Ann Thorac Surg. 2020;110(5):e413−5. https://doi.org/10.1016/j.athoracsur.2020.04.011
Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation. World J Crit Care Med. 2014;3(1):8−14. https://doi.org/10.5492/wjccm.v3.i1.8
Aydin S, Öz G, Dumanli A, Balci A, Gencer A. A case of spontaneous pneumothorax in Covid-19 pneumonia. J Surg Res. 2020;3(2):096−101. https://doi.org/10.26502/jsr.10020060
Sun R, Liu H, Wang X. Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol. 2020;21(5):541−4. https://doi.org/10.3348/kjr.2020.0180
Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020;46(6):1099−102. https://doi.org/10.1007/s00134-020-06033-2
Wright BJ. Lung-protective ventilation strategies and adjunctive treatments for the emergency medicine patient with acute respiratory failure. Emerg Med Clin North Am. 2014;32(4):871−87. https://doi.org/10.1016/j.emc.2014.07.012
Möhlenkamp S, Thiele H. Ventilation of COVID-19 patients in intensive care units. Herz. 2020:1−3. https://doi.org/10.1007/s00059-020-04923-1
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