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BMC Pulm Med ; 21(1): 307, 2021 Sep 27.
Article in English | MEDLINE | ID: covidwho-1440925

ABSTRACT

BACKGROUND: The main clinical consequences of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are pneumonia and respiratory failure even requiring mechanical ventilation. In this context, the lung parenchyma is highly prone to ventilator-related injury, with pneumothorax and persistent air leak as the most serious adverse events. So far, endobronchial valve (EBV) positioning has proved efficacious in treating air leaks with a high success rate. CASE PRESENTATION: We report, for the first time, two cases of patients affected by SARS-CoV-2-related pneumonia complicated with bacterial super-infection, experiencing pneumothorax and persistent air leaks after invasive mechanical ventilation. Despite the severity of respiratory failure both patients underwent rigid interventional bronchoscopy and were successfully treated through EBV positioning. CONCLUSIONS: Persistent air leaks may result from lung tissue damage due to a complex interaction between inflammation and ventilator-related injury (VILI), especially in the advanced stages of ARDS. EBV positioning seems to be a feasible and effective minimally invasive therapeutic option for treating this subset of patients.


Subject(s)
Bronchial Fistula/surgery , COVID-19/therapy , Pleural Diseases/surgery , Pneumothorax/surgery , Respiration, Artificial/adverse effects , Aged , Bronchoscopy/methods , COVID-19/diagnosis , Humans , Intensive Care Units , Male , Respiratory Tract Fistula/surgery , SARS-CoV-2/genetics , Tomography, X-Ray Computed
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