Expectant management of pneumothorax in intubated COVID-19 positive patients: a case series.
Identifieur interne : 000146 ( Main/Corpus ); précédent : 000145; suivant : 000147Expectant management of pneumothorax in intubated COVID-19 positive patients: a case series.
Auteurs : Colby Elder ; Sheina Bawa ; Douglas Anderson ; Stephen Atkinson ; Joshua Etzel ; Troy MoritzSource :
- Journal of cardiothoracic surgery [ 1749-8090 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (therapy), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (therapy), Pneumothorax (etiology), Pneumothorax (therapy), Positive-Pressure Respiration (adverse effects), Watchful Waiting (MeSH).
- MESH :
- adverse effects : Positive-Pressure Respiration.
- etiology : Pneumothorax.
- therapy : Coronavirus Infections, Pneumonia, Viral, Pneumothorax.
- Aged, Betacoronavirus, Female, Humans, Male, Middle Aged, Pandemics, Watchful Waiting.
Abstract
BACKGROUND
There is an increasing amount of literature describing the pathogenesis of coronavirus disease 2019 (COVID-19) pneumonia and its associated complications. Historically, a small pneumothorax has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia patients. In addition, pneumothorax in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management.
CASE PRESENTATION
In this series we report four cases of patients with respiratory distress who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces which were successfully managed with observation alone.
CONCLUSIONS
Management of patients with COVID-19 pneumonia on positive pressure ventilation who develop small stable pneumothoraces can be safely observed without chest tube insertion.
DOI: 10.1186/s13019-020-01297-7
PubMed: 32958067
PubMed Central: PMC7504875
Links to Exploration step
pubmed:32958067Le document en format XML
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<affiliation><nlm:affiliation>UPMC Pinnacle Harrisburg, 205 S. Front St. Brady Hall 9th Floor, Room 96, Harrisburg, PA, 17104, USA. elderca@upmc.edu.</nlm:affiliation>
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<author><name sortKey="Bawa, Sheina" sort="Bawa, Sheina" uniqKey="Bawa S" first="Sheina" last="Bawa">Sheina Bawa</name>
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<author><name sortKey="Anderson, Douglas" sort="Anderson, Douglas" uniqKey="Anderson D" first="Douglas" last="Anderson">Douglas Anderson</name>
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<author><name sortKey="Atkinson, Stephen" sort="Atkinson, Stephen" uniqKey="Atkinson S" first="Stephen" last="Atkinson">Stephen Atkinson</name>
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<author><name sortKey="Moritz, Troy" sort="Moritz, Troy" uniqKey="Moritz T" first="Troy" last="Moritz">Troy Moritz</name>
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<author><name sortKey="Bawa, Sheina" sort="Bawa, Sheina" uniqKey="Bawa S" first="Sheina" last="Bawa">Sheina Bawa</name>
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<term>Coronavirus Infections (therapy)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (therapy)</term>
<term>Pneumothorax (etiology)</term>
<term>Pneumothorax (therapy)</term>
<term>Positive-Pressure Respiration (adverse effects)</term>
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<term>Pneumonia, Viral</term>
<term>Pneumothorax</term>
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<term>Betacoronavirus</term>
<term>Female</term>
<term>Humans</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>There is an increasing amount of literature describing the pathogenesis of coronavirus disease 2019 (COVID-19) pneumonia and its associated complications. Historically, a small pneumothorax has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia patients. In addition, pneumothorax in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CASE PRESENTATION</b>
</p>
<p>In this series we report four cases of patients with respiratory distress who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces which were successfully managed with observation alone.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Management of patients with COVID-19 pneumonia on positive pressure ventilation who develop small stable pneumothoraces can be safely observed without chest tube insertion.</p>
</div>
</front>
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