Clinical Characteristics of the Development of Pneumothorax in Mechanically Ventilated Patients in Intensive Care Units.
10.4266/kjccm.2014.29.1.13
- Author:
Wan Chul KIM
1
;
Su Jin LIM
;
Kyong Young KIM
;
Seung Jun LEE
;
Yu Ji CHO
;
Yi Yeong JEONG
;
Mi Jung PARK
;
Kyoung Nyeo JEON
;
Jong Deog LEE
;
Young Sil HWANG
;
Ho Cheol KIM
Author Information
1. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. hochkim@gnu.ac.kr
- Publication Type:Original Article
- Keywords:
intensive care unit;
mechanical ventilation;
pneumothorax
- MeSH:
Blood Pressure;
Catheters;
Chest Tubes;
Diagnosis;
Female;
Heart Rate;
Hemodynamics;
Humans;
Intensive Care Units*;
Critical Care*;
Lung Diseases;
Lung Diseases, Interstitial;
Male;
Pneumothorax*;
Positive-Pressure Respiration;
Pulmonary Disease, Chronic Obstructive;
Radiography;
Respiration, Artificial;
Respiratory Distress Syndrome, Adult;
Retrospective Studies;
Thorax;
Tidal Volume
- From:The Korean Journal of Critical Care Medicine
2014;29(1):13-18
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Pneumothorax (PTX) can occur as a complication of positive pressure ventilation in mechanically ventilated patients. METHODS: We retrospectively reviewed the clinical characteristics of patients who developed PTX during mechanical ventilation (MV) in the intensive care unit (ICU). RESULTS: Of the 326 patients admitted (208 men and 118 women; mean age, 65.3 +/- 8.74 years), 15 (4.7%) developed PTX, which was MV-associated in 11 (3.3%) cases (6 men and 5 women; mean age, 68.3 +/- 9.12 years) and procedure-associated in 4. Among the patients with MV-associated PTX, the underlying lung diseases were acute respiratory distress syndrome in 7 patients, interstitial lung disease in 2 patients, and chronic obstructive pulmonary disease in 2 patients. PTX diagnosis was achieved by chest radiography alone in 9 patients and chest computed tomography alone in 2 patients. Nine patients were using assist-control mode MV with the mean applied positive end-expiratory pressure, 9 +/- 4.6 cmH2O and the mean tidal volume, 361 +/- 63.7 ml at the diagnosis of PTX. Two patients died as a result of MV-associated PTX and their systolic pressure was below 80 mmHg and heart rates were less than 80/min. Ten patients were treated by chest tube insertion, and 1 patient was treated by percutaneous pigtail catheter insertion. CONCLUSIONS: PTX can develop in patients undergoing MV, and may cause death. Early recognition and treatment are necessary to prevent hemodynamic compromise in patients who develop PTX.
