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Endobronchial valve positioning for alveolar-pleural fistula following ICU management complicating COVID-19 pneumonia.
Donatelli, Pierluigi; Trentacosti, Fabiana; Pellegrino, Maria Rosaria; Tonelli, Roberto; Bruzzi, Giulia; Andreani, Alessandro; Cappiello, Gaia Francesca; Andrisani, Dario; Gozzi, Filippo; Mussini, Cristina; Busani, Stefano; Cavaliere, Gilda Valentina; Girardis, Massimo; Bertellini, Elisabetta; Clini, Enrico; Marchioni, Alessandro.
  • Donatelli P; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Trentacosti F; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Pellegrino MR; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Tonelli R; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy. roberto.tonelli@me.com.
  • Bruzzi G; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Via Università 4, 41121, Modena, Italy. roberto.tonelli@me.com.
  • Andreani A; Laboratory of Experimental Pneumology, Modena, Italy. roberto.tonelli@me.com.
  • Cappiello GF; Respiratory Diseases Unit and Center for Rare Lung Disease, Department of Surgical and Medical Sciences, University Hospital of Modena, Via del Pozzo, 71, 41125, Modena, Italy. roberto.tonelli@me.com.
  • Andrisani D; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Gozzi F; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Mussini C; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Busani S; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Cavaliere GV; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Via Università 4, 41121, Modena, Italy.
  • Girardis M; University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
  • Bertellini E; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Via Università 4, 41121, Modena, Italy.
  • Clini E; University Hospital of Modena, Infectious Diseases Unit, University of Modena Reggio Emilia, Modena, Italy.
  • Marchioni A; University Hospital of Modena, Anesthesiology Unit, University of Modena Reggio Emilia, Modena, Italy.
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pleural Diseases / Pneumothorax / Respiration, Artificial / Bronchial Fistula / COVID-19 Type of study: Diagnostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article Affiliation country: S12890-021-01653-W

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pleural Diseases / Pneumothorax / Respiration, Artificial / Bronchial Fistula / COVID-19 Type of study: Diagnostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article Affiliation country: S12890-021-01653-W