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Ann Thorac Surg ; 112(4): e265-e266, 2021 10.
Article in English | MEDLINE | ID: covidwho-1056318


Tension pneumomediastinum is a rare but life-threatening cause of tamponade. Mechanical ventilation is a described source of tension pneumomediastinum. Here, we present a case of a 72-year-old man who developed cardiovascular collapse from tension pneumomediastinum in the setting of coronavirus disease 2019-related acute respiratory distress syndrome. We successfully performed bedside mediastinotomy and mediastinal tube placement under local anesthetic to alleviate his hemodynamic instability. Bedside mediastinotomy can be used to relieve tension pneumomediastinum in this setting.

COVID-19/complications , Cardiac Tamponade/etiology , Mediastinal Emphysema/surgery , Mediastinum/surgery , SARS-CoV-2 , Aged , Humans , Male , Mediastinal Emphysema/complications , Mediastinal Emphysema/diagnostic imaging
Ann Thorac Surg ; 110(5): e417-e419, 2020 11.
Article in English | MEDLINE | ID: covidwho-884669


Severe acute respiratory syndrome coronavirus 2 disease 2019 (COVID-19) has rapidly spread worldwide since December 2019. An acute respiratory distress syndrome develops in a relevant rate of patients, who require hospitalization. Among them, a nonnegligible rate of 9.8% to 15.2% of patients requires tracheal intubation for invasive ventilation. We report the case of a pneumomediastinum and subcutaneous emphysema developing in a COVID-19 patient secondary to postintubation tracheal injury. The management of COVID-19 patients can be challenging due to the risk of disease transmission to caregivers and epidemic spread. We performed a bedside tracheal injury surgical repair, after failure of conservative management, with resolution of pneumomediastinum and subcutaneous emphysema and improvement of the patient's conditions.

Betacoronavirus , Coronavirus Infections/therapy , Intubation, Intratracheal/adverse effects , Mediastinal Emphysema/surgery , Pneumonia, Viral/therapy , Subcutaneous Emphysema/surgery , Thoracic Surgical Procedures/methods , Trachea/injuries , Aged , COVID-19 , Coronavirus Infections/epidemiology , Humans , Male , Mediastinal Emphysema/diagnosis , Mediastinal Emphysema/etiology , Neck , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Subcutaneous Emphysema/diagnosis , Subcutaneous Emphysema/etiology , Tomography, X-Ray Computed