3
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Successful use of endobronchial valve for persistent air leak in a patient with COVID-19 and bullous emphysema

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5–7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.

          Related collections

          Most cited references40

          • Record: found
          • Abstract: found
          • Article: not found

          Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement.

          Provide explicit expert-based consensus recommendations for the management of adults with primary and secondary spontaneous pneumothoraces in an emergency department and inpatient hospital setting. The use of opinion was made explicit by employing a structured questionnaire, appropriateness scores, and consensus scores with a Delphi technique. The guideline was designed to be relevant to physicians who make management decisions for the care of patients with pneumothorax. Decisions for observation, chest tube placement, surgical interventions, and radiographic imaging. Effectiveness of pneumothorax resolution, duration of and patient tolerance of care, and pneumothorax recurrence. Literature review from 1967 to January 1999 and Delphi questionnaire submitted in three iterations to a multidisciplinary physician panel. The guideline development group determined by consensus the relevant outcomes to be considered in developing the Delphi questionnaire. The type and magnitude of benefits, harms, and costs expected for patients from guideline implementation. Management decisions vary between patients with primary or secondary pneumothoraces, with observation of small pneumothoraces being appropriate only for primary pneumothoraces. The level of consensus varies regarding the specific interventions indicated, but agreement exists for the general principles of care. Recommendations were peer reviewed by physician experts and were reviewed by the American College of Chest Physicians (ACCP) Health and Science Policy Committee. The guideline recommendations will be published in printed and electronic form with distribution of synopses for patients and health care providers. Contents of the guideline will be incorporated into continuing medical education programs. The ACCP.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Pleural procedures and thoracic ultrasound: British Thoracic Society Pleural Disease Guideline 2010.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              COVID-19 and Pneumothorax: A Multicentre Retrospective Case Series

              Introduction Pneumothorax and pneumomediastinum have both been noted to complicate cases of COVID-19 requiring hospital admission. We report the largest case series yet described of patients with both these pathologies that includes non-ventilated patients. Methods Cases were collected retrospectively from UK hospitals with inclusion criteria limited to a diagnosis of COVID-19 and the presence of either pneumothorax or pneumomediastinum. Patients included in the study presented between March and June 2020. Details obtained from the medical record included demographics, radiology, laboratory investigations, clinical management and survival. Results Seventy-one patients from 16 centres were included in the study, of whom 60 patients had pneumothoraces (six also with pneumomediastinum), whilst 11 patients had pneumomediastinum alone. Two of these patients had two distinct episodes of pneumothorax, occurring bilaterally in sequential fashion, bringing the total number of pneumothoraces included to 62. Clinical scenarios included patients who had presented to hospital with pneumothorax, patients who had developed pneumothorax or pneumomediastinum during their inpatient admission with COVID-19 and patients who developed their complication whilst intubated and ventilated, either with or without concurrent extracorporeal membrane oxygenation. Survival at 28 days was not significantly different following pneumothorax (63.1%±6.5%) or isolated pneumomediastinum (53.0%±18.7%; p=0.854). The incidence of pneumothorax was higher in males. The 28-day survival was not different between the sexes (males 62.5%±7.7% versus females 68.4%±10.7%; p=0.619). Patients above the age of 70 had a significantly lower 28-day survival than younger individuals (≥70 years 41.7%±13.5% survival versus <70 years 70.9%±6.8% survival; p=0.018 log-rank). Conclusion These cases suggest that pneumothorax is a complication of COVID-19. Pneumothorax does not seem to be an independent marker of poor prognosis and we encourage active treatment to be continued where clinically possible.
                Bookmark

                Author and article information

                Journal
                BMJ Case Rep
                BMJ Case Rep
                bmjcr
                bmjcasereports
                BMJ Case Reports
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1757-790X
                2021
                19 November 2021
                19 November 2021
                : 14
                : 11
                : e246671
                Affiliations
                [1 ]departmentPulmonary and Critical Care Medicine , Ozarks Medical Center , West Plains, Missouri, USA
                [2 ]departmentDepartment of Nursing , Goldfarb School of Nursing at Barnes-Jewish College , St Louis, Missouri, USA
                [3 ]departmentPulmonary and Critical Care Medicine , Albany Medical Center , Albany, New York, USA
                [4 ]departmentPulmonary and Critical Care Medicine , Washington University School of Medicine in Saint Louis , St Louis, Missouri, USA
                Author notes
                [Correspondence to ] Dr Biplab K Saha; spanophiliac@ 123456yahoo.com
                Author information
                http://orcid.org/0000-0002-3595-8804
                http://orcid.org/0000-0002-2070-3585
                Article
                bcr-2021-246671
                10.1136/bcr-2021-246671
                8606771
                34799393
                f6d61bc5-b669-4e79-9e7e-f32a71fe498f
                © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

                This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

                History
                : 25 October 2021
                Categories
                Case Report
                2474
                508
                515
                Custom metadata
                free

                air leaks,covid-19,pneumothorax,pulmonary emphysema
                air leaks, covid-19, pneumothorax, pulmonary emphysema

                Comments

                Comment on this article