Barotrauma due to mechanical ventilation

Case contributed by Dr David Cuete

Presentation

Patient with respiratory impairment after mechanical ventilation.

Patient Data

Age: 60
Gender: Female

CT Chest

Modality: CT

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

Case Discussion

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.

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Case Information

rID: 28079
Case created: 8th Mar 2014
Last edited: 18th May 2017
System: Chest
Inclusion in quiz mode: Included

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