Early Period Results in Patients Developing
Pneumothorax and Pneumomediastinum
Due to COVID-19 Pneumonia: Single-Center
Clinical Experience on 47 Cases

SEVİLGEN, GÖKÇEN; Tülüce, Kerim; TÜRÜT, HASAN

doi:10.14744/scie.2022.03764

Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases

Gökçen Sevilgen, (Göğüs Cerrahisi Anabilim Dalı, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Rize, Türkiye)

Kerim Tülüce, (Göğüs Cerrahisi Anabilim Dalı, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Rize, Türkiye)

Hasan Türüt (Göğüs Cerrahisi Anabilim Dalı, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Rize, Türkiye)

Southern Clinics of Istanbul Eurasia

0 1

Yıl: 2022 Cilt: 33 Sayı: 2 Sayfa Aralığı: 174 - 179 Metin Dili: İngilizce DOI: 10.14744/scie.2022.03764 İndeks Tarihi: 21-07-2022

Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases

Öz:

Objective: Pneumothorax (PNX) and/or pneumomediastinum (PNM) is an entity that can occur as late findings in COVID-19 patients with mechanical ventilator support. The purpose of this study was to determine the parameters that influence morbidity and mortality asso- ciated with PNX and/or PNM secondary to COVID-19 infection. Methods: The study was performed on patients from March 2020 to December 2020. De- mographic data, comorbidities, positive end-expiratory pressure (PEEP) values, and fraction of inspired oxygen (FiO 2) percentage were analyzed. Mortality in the first 48 h, between 48 h and 7 days, and after 7 days was assayed. Results: A total of 47 patients, only 2 of whom (4%) were in 20–40 years of age, were studied. The result was statistically significant (p<0.03). Bilateral PNX was seen in 5 patients (11%). Tube thoracostomy was performed in 40 patients (85%). The isolated PM was de- tected as a single finding in 11 patients (23%). The mean age was 62 years. The mean me- chanical ventilator PEEP and the FiO2 values were 11 cmH2O and 84%, respectively. When the mortality of the first 48 h and the first 7 days was compared, no statistically significant difference was found. However, a significant difference in the mortality observed after the 7th day, which is consistent with the literature, and the presence of diffuse subcutaneous emphysema was detected (p<0.05). Conclusion: Tube thoracostomy is a highly effective method for treating PNX in all pa- tients. Due to the elevated risk of PNX associated with the development of PNM in patients receiving mechanical ventilation, we suggest that more sensitive and earlier lung-protective breathing methods should be used

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. T.C. Sağlık Bakanlığı Covid-19 bilgilendirme platformu. Available at: https://covid19. saglik.gov.tr. Accessed May 11, 2022.
2. Yao W, Wang T, Jiang B, Gao F, Wang L, Zheng H, et al. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth 2020;125:e28–e37.
3. Sihoe AD, Wong RH, Lee AT, Lau LS, Leung NY, Law KI, et al. Se- vere acute respiratory syndrome complicated by spontaneous pneu- mothorax. Chest 2004;125:2345–51.
4. Light RW. Management of spontaneous pneumothorax. Am Rev Re- spir Dis 1993;148:245–8.
5. Macklin MT, Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: interpretation of the clinical literature in the light of laboratory experiment. Medicine 1944;23:281–358.
6. Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane ND, et al. COVID-19 and pneumothorax: a multicentre retrospective case series. Eur Respir J 2020;56:2002697.
7. Joynt GM, Antonio GE, Lam P, Wong KT, Li T, Gomersall CD, et al. Late-stage adult respiratory distress syndrome caused by severe acute respiratory syndrome: abnormal findings at thin-section CT. Radiol- ogy 2004;230:339–46.
8. Bellini R, Salandini MC, Cuttin S, Mauro S, Scarpazza P, Cotsoglou C. Spontaneous pneumothorax as unusual presenting symptom of
COVID-19 pneumonia: surgical management and pathological find- ings. J Cardiothorac Surg 2020;15:310.
9. Aiolfi A, Biraghi T, Montisci A, Bonitta G, Micheletto G, Donatelli F, et al. Management of persistent pneumothorax with thoracoscopy and bleb resection in COVID-19 patients. Ann Thorac Surg 2020;110:413–5.
10. McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM, et al. Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation. Radiology 2020;297:252–62.
11. Panigrahi MK, Suresh Kumar C, Jaganathan V, Vinod Kumar S. Spontaneous pneumomediastinum: Experience in 13 adult patients. Asian Cardiovasc Thorac Ann 2015;23:1050–5.
12. Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assess- ment and management of spontaneous pneumomediastinum: experi- ence in 24 adult patients. Eur J Cardiothorac Surg 2004;25:852–5.
13. Schaller T, Hirschbühl K, Burkhardt K, Braun G, Trepel M, Märkl B, et al. Postmortem examination of patients with COVID-19. JAMA 2020;323:2518–20.
14. Wang J, Su X, Zhang T, Zheng C. Spontaneous pneumomedi- astinum: a probable unusual complication of coronavirus disease 2019 (COVID-19) pneumonia. Korean J Radiol 2020;21:627–8.
15. López Vega JM, Parra Gordo ML, Diez Tascón A, Ossaba Vélez S. Pneumomediastinum and spontaneous pneumothorax as an ex- trapulmonary complication of COVID-19 disease. Emerg Radiol 2020;27:727–30.
16. Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep 2020;13:e236519

APA	SEVİLGEN G, Tülüce K, TÜRÜT H (2022). Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. , 174 - 179. 10.14744/scie.2022.03764
Chicago	SEVİLGEN GÖKÇEN,Tülüce Kerim,TÜRÜT HASAN Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. (2022): 174 - 179. 10.14744/scie.2022.03764
MLA	SEVİLGEN GÖKÇEN,Tülüce Kerim,TÜRÜT HASAN Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. , 2022, ss.174 - 179. 10.14744/scie.2022.03764
AMA	SEVİLGEN G,Tülüce K,TÜRÜT H Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. . 2022; 174 - 179. 10.14744/scie.2022.03764
Vancouver	SEVİLGEN G,Tülüce K,TÜRÜT H Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. . 2022; 174 - 179. 10.14744/scie.2022.03764
IEEE	SEVİLGEN G,Tülüce K,TÜRÜT H "Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases." , ss.174 - 179, 2022. 10.14744/scie.2022.03764
ISNAD	SEVİLGEN, GÖKÇEN vd. "Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases". (2022), 174-179. https://doi.org/10.14744/scie.2022.03764

APA	SEVİLGEN G, Tülüce K, TÜRÜT H (2022). Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. Southern Clinics of Istanbul Eurasia, 33(2), 174 - 179. 10.14744/scie.2022.03764
Chicago	SEVİLGEN GÖKÇEN,Tülüce Kerim,TÜRÜT HASAN Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. Southern Clinics of Istanbul Eurasia 33, no.2 (2022): 174 - 179. 10.14744/scie.2022.03764
MLA	SEVİLGEN GÖKÇEN,Tülüce Kerim,TÜRÜT HASAN Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. Southern Clinics of Istanbul Eurasia, vol.33, no.2, 2022, ss.174 - 179. 10.14744/scie.2022.03764
AMA	SEVİLGEN G,Tülüce K,TÜRÜT H Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. Southern Clinics of Istanbul Eurasia. 2022; 33(2): 174 - 179. 10.14744/scie.2022.03764
Vancouver	SEVİLGEN G,Tülüce K,TÜRÜT H Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases. Southern Clinics of Istanbul Eurasia. 2022; 33(2): 174 - 179. 10.14744/scie.2022.03764
IEEE	SEVİLGEN G,Tülüce K,TÜRÜT H "Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases." Southern Clinics of Istanbul Eurasia, 33, ss.174 - 179, 2022. 10.14744/scie.2022.03764
ISNAD	SEVİLGEN, GÖKÇEN vd. "Early Period Results in Patients Developing Pneumothorax and Pneumomediastinum Due to COVID-19 Pneumonia: Single-Center Clinical Experience on 47 Cases". Southern Clinics of Istanbul Eurasia 33/2 (2022), 174-179. https://doi.org/10.14744/scie.2022.03764