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      Life threatening tension pneumothorax during cardiac surgery. A case report

      case-report

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          Abstract

          Tension pneumothorax is a life threatening condition that occurs when the intrapleural pressure exceeds atmospheric pressure. It requires prompt diagnosis and immediate treatment. Tension pneumothorax developing postoperatively after cardiac surgery is not uncommon but occurrence in the operating room during cardiac surgery is rare. We report a case of tension pneumothorax intraoperatively during off pump coronary artery bypass grafting.

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          Most cited references11

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          Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

          Derek J Roberts, Simon Leigh-Smith, Peter Faris … (2014)
          Background Although health care providers utilize classically described signs and symptoms to diagnose tension pneumothorax, available literature sources differ in their descriptions of its clinical manifestations. Moreover, while the clinical manifestations of tension pneumothorax have been suggested to differ among subjects of varying respiratory status, it remains unknown if these differences are supported by clinical evidence. Thus, the primary objective of this study is to systematically describe and contrast the clinical manifestations of tension pneumothorax among patients receiving positive pressure ventilation versus those who are breathing unassisted. Methods/Design We will search electronic bibliographic databases (MEDLINE, PubMed, EMBASE, and the Cochrane Database of Systematic Reviews) and clinical trial registries from their first available date as well as personal files, identified review articles, and included article bibliographies. Two investigators will independently screen identified article titles and abstracts and select observational (cohort, case–control, and cross-sectional) studies and case reports and series that report original data on clinical manifestations of tension pneumothorax. These investigators will also independently assess risk of bias and extract data. Identified data on the clinical manifestations of tension pneumothorax will be stratified according to whether adult or pediatric study patients were receiving positive pressure ventilation or were breathing unassisted, as well as whether the two investigators independently agreed that the clinical condition of the study patient(s) aligned with a previously published tension pneumothorax working definition. These data will then be summarized using a formal narrative synthesis alongside a meta-analysis of observational studies and then case reports and series where possible. Pooled or combined estimates of the occurrence rate of clinical manifestations will be calculated using random effects models (for observational studies) and generalized estimating equations adjusted for reported potential confounding factors (for case reports and series). Discussion This study will compile the world literature on tension pneumothorax and provide the first systematic description of the clinical manifestations of the disorder according to presenting patient respiratory status. It will also demonstrate a series of methods that may be used to address difficulties likely to be encountered during the conduct of a meta-analysis of data contained in published case reports and series. PROSPERO registration number: CRD42013005826.
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            Tension pneumothorax: a difficult diagnosis.

            Nelson B. Watts, Josselyn M. Howell (2001)
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              Pneumothorax and systemic air embolism during positive-pressure ventilation.

              Leena Ibrahim, Nancy Stanwood, Herbert Freund (1999)
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Heart Lung Vessel
                Journal ID (iso-abbrev): Heart Lung Vessel
                Journal ID (issn): 2282-8419
                Journal ID (publisher-id): hlv
                Title: Heart, Lung and Vessels
                Publisher: EDIMES Edizioni Internazionali Srl
                ISSN (Print): 2282-8419
                ISSN (Electronic): 2283-3420
                Publication date (Print): 2014
                Volume: 6
                Issue: 3
                Pages: 204-207
                Affiliations
                Medanta Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana
                Author notes
                Dr. Ashish Jain DNB Anesthesia Medanta - The Medicity Sector 38, Gurgaon, Haryana, INDIA; E-mail: drashishjain07@ 123456rediffmail.com
                Article
                Publisher ID: 201403204
                PMC ID: 4181282
                SO-VID: 13fba113-05e8-410b-8343-bf6f4b5688dd
                Copyright © Copyright © 2014, Heart, Lung and Vessels
                License:

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Case-Report

                Keywords: pneumothorax,cardiac surgery,hypotension
                Data availability:
                Keywords: pneumothorax, cardiac surgery, hypotension

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