Barotrauma due to mechanical ventilation
Patient with respiratory impairment after mechanical ventilation.
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Computed tomography demonstrated bilateral pneumothorax, pneumomediastinum, extensive subcutaneous emphysema in cervical regions, anterior chest wall. It is also obvious pneumoperitoneum. There is right pleural effusion and areas of higher in the lung parenchyma density corresponding to pneumonic foci. Endotracheal tube well located
In this case these appearances are typical of barotrauma. The Barotrauma occurs between 4 and 15% of all patients undergoing mechanical ventilation.
Pulmonary barotrauma is the alveolar rupture due to the use of positive pressure. Clinical manifestations of barotrauma are multiple interstitial emphysema, pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumoperitoneum, tension lung cysts, and subpleural air cysts. As noted, all these forms of barotrauma are developed by a ruptured alveolus overdistended with with penetration of air into the perivascular interstitium or interstitial emphysema.