Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 20 , ISSUE 4 ( 2016 ) > List of Articles

CASE REPORT

Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus

Lara González-García, Corsino Rey, Alberto Medina, Juan Mayordomo-Colunga

Keywords : Asthma, noninvasive ventilation, pneumomediastinum, subcutaneous emphysema

Citation Information : González-García L, Rey C, Medina A, Mayordomo-Colunga J. Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus. Indian J Crit Care Med 2016; 20 (4):242-244.

DOI: 10.4103/0972-5229.180047

License: CC BY-ND 3.0

Published Online: 01-10-2013

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

A 12-year-old male with status asthmaticus developed subcutaneous emphysema and pneumomediastinum. He was transferred to our unit, where he received noninvasive ventilation (NIV). This respiratory support technique is not an absolute contraindication in these cases. After 2 h on NIV, he worsened sharply and the subcutaneous emphysema got bigger suddenly. He needed invasive ventilation for 5 days. Final outcome was satisfactory. This case illustrates that it is mandatory to keep a high level of vigilance when using NIV in patients with air leaks.


PDF Share
  1. Zhang XY, Zhang WX, Sheng AQ, Zhang HL, Li CC. Diagnosis and prognosis of spontaneous pneumomediastinum in eighteen children. Zhonghua Er Ke Za Zhi 2013;51:849-51.
  2. Meireles J, Neves S, Castro A, França M. Spontaneous pneumomediastinum revisited. Respir Med CME 2011;4:181-8.
  3. Reed JA, Larson KE, Hsu BS. Spontaneous pneumomediastinum with subcutaneous emphysema: Report of two pediatric cases. S D Med 2013;66:89, 91-3.
  4. Giuliani S, Franklin A, Pierce J, Ford H, Grikscheit TC. Massive subcutaneous emphysema, pneumomediastinum, and pneumopericardium in children. J Pediatr Surg 2010;45:647-9.
  5. Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in admissions for pediatric status asthmaticus in New Jersey over a 15-year period. Pediatrics 2010;126:e904-11.
  6. Carroll CL, Zucker AR. Barotrauma not related to type of positive pressure ventilation during severe asthma exacerbations in children. J Asthma 2008;45:421-4.
  7. Fuchs H, Schoss J, Mendler MR, Lindner W, Hopfner R, Schulz A, et al. The cause of acute respiratory failure predicts the outcome of noninvasive ventilation in immunocompromised children. Klin Padiatr 2015;227:322-8.
  8. Ruggeri P, Girbino G. Fatal pneumomediastinum associated with use of noninvasive mechanical ventilation. Respirol Case Rep 2014;2:126-8.
  9. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet 2009;374:250-9.
  10. Francisco PA, Pamela SF, Gustavo PT, Carolina CO, Daniel ZA. Asistencia ventilatoria no invasiva en pediatría. Rev Chil Pediatr 2008;79:580-92.
  11. Medina A, Pons-Òdena M, Martinón-Torres F, editores. Noninvasive ventilation in pediatrics, 3 rd ed. Madrid: Ergon; 2015.
  12. Akingbola OA, Hopkins RL. Pediatric noninvasive positive pressure ventilation. Pediatr Crit Care Med 2001;2:164-9.
  13. Caples SM, Gay PC. Noninvasive positive pressure ventilation in the intensive care unit: A concise review. Crit Care Med 2005;33:2651-8.
  14. Essouri S, Chevret L, Durand P, Haas V, Fauroux B, Devictor D. Noninvasive positive pressure ventilation: Five years of experience in a pediatric intensive care unit. Pediatr Crit Care Med 2006;7:329-34.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.