Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 11 , ISSUE 1 ( January-March, 2022 ) > List of Articles

CASE REPORT

Spectrum of Barotraumatic Events in COVID-19 Patients on High-Resolution Computed Tomography

Kamal Kumar Sen, Roopak Dubey, Sudhansu Sekhar Mohanty, Mayank Goyal, Asim Mitra, Jagadeesh Kuniyil

Keywords : Barotrauma, mechanical ventilation, pneumomediastinum, pneumothorax, subcutaneous emphysema

Citation Information : Sen KK, Dubey R, Mohanty SS, Goyal M, Mitra A, Kuniyil J. Spectrum of Barotraumatic Events in COVID-19 Patients on High-Resolution Computed Tomography. Indian J Respir Care 2022; 11 (1):67-70.

DOI: 10.4103/ijrc.ijrc_115_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Abstract

Barotrauma has many different presentations, including pneumothorax, subcutaneous emphysema, pneumoperitoneum, and pneumomediastinum. We have presented and analyzed some interesting cases of barotrauma in this case series. Case 1 in our series developed a thin-walled new cavity due to barotrauma, mimicking pneumatocele and fungal cavity. Case 2 presented with coexistence of pneumothorax and cavity with fungal infestation. Severity of barotrauma due to positive pressure ventilation has been shown in case 3. An interesting case of barotrauma in a 36-week primigravida, post cesarean section, causing dehiscence of scar, presented as case 4 in our series. Early and rapid imaging diagnosis of barotrauma should be pursued. In patients with mechanical ventilation, identifying small changes in imaging characteristics of cavitary lesions, such as fungal, bacterial, or transient cavities, would aid physicians in offering a correct treatment plan.


HTML PDF Share
  1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA 2020;323:1239-42.
  2. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020;395:1054-62.
  3. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of COVID-19 in New York city. N Engl J Med 2020;382:2372-4.
  4. McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM, et al. Increased incidence of barotrauma in patients with COVID-19 on invasive mechanical ventilation. Radiology 2020;297:E252-62.
  5. Lemmers DH, Abu Hilal M, Bnà C, Prezioso C, Cavallo E, Nencini N, et al. Pneumomediastinum and subcutaneous emphysema in COVID-19: Barotrauma or lung frailty? ERJ Open Res 2020;6:00385-2020.
  6. Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane ND, et al. COVID-19 and pneumothorax: A multicentre retrospective case series. Eur Respir J 2020;56:2002697.
  7. Gammon RB, Shin MS, Buchalter SE. Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors. Chest 1992;102:568-72.
  8. Eisner MD, Thompson BT, Schoenfeld D, Anzueto A, Matthay MA; Acute Respiratory Distress Syndrome Network. Airway pressures and early barotrauma in patients with acute lung injury and acute respiratory distress syndrome. Am J Respir Crit Care Med 2002;165:978-82.
  9. de Lassence A, Timsit JF, Tafflet M, Azoulay E, Jamali S, Vincent F, et al. Pneumothorax in the intensive care unit: Incidence, risk factors, and outcome. J Am Soc Anesthesiol 2006;104:5-13.
  10. Boisset GF. Subpleural emphysema complicating staphylococcal and other pneumonias. J Pediatr 1972;81:259-66.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.