[Source: Thorax, full page: (LINK). Summary, edited.]
Tension pneumomediastinum in patients with COVID-19
Alessio Campisi 1, Venerino Poletti 2,3, Angelo Paolo Ciarrocchi 1, Maurizio Salvi 4, Franco Stella 1
Author affiliations: 1 Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, University of Bologna, Forlì, Italy; 2 Pulmonary Operative Unit, Department of Thoracic Diseases, Morgagni-Pierantoni Hospital, AUSL of Romagna, Forli’, Italy; 3 Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; 4 Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, AUSL della Romagna Rimini, Forlì, Italy;
Correspondence to Dr Alessio Campisi, Thoracic Surgery Unit, Department of Thoracic Diseases, G.B. Morgagni-L. Pierantoni Hospital, University of Bologna, Forlì, Emilia-Romagna, Italy; firstname.lastname@example.org
A 65-year-old obese male, with no other comorbidities, was admitted to our intensive care unit for acute respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient was mechanically ventilated (intermittent positive pressure ventilation autoflow mode with tidal volume of 6 mL/kg, positive end expiratory pressure (PEEP) 12 cmH2O, respiratory rate 20 breaths/min and fractional inspired oxygen (FiO2) to the lowest level to maintain arterial pO2 in a range of 55–60 mm Hg) for 7 days before his condition abruptly worsened. He became haemodynamically unstable with changes in the cardiac electrical activity and hypotension unresponsive to catecholamines. An initial plain chest X-ray revealed widespread subcutaneous emphysema.
Keywords: SARS-CoV-2; COVID-19; ARDS; Intensive Care.