scholarly journals Tracheal Diverticulum in SARS-CoV-2 Patients on Non-Invasive Ventilation A not so “Spontaneous” Cause of Pneumomediastinum? An imaging Pictorial Presentation of Two Cases with Review of Literature

2021 ◽  
Vol 28 (2) ◽  
pp. 19
Author(s):  
Veena Mariam Joseph ◽  
Donboklang Lynser ◽  
Iadarilang Tiewsoh ◽  
Kaustuv Dutta ◽  
Pranjal Phukan ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive ◽  
Pictorial Presentation ◽  
Tracheal Diverticulum ◽  
Free Air ◽  
Non Invasive Ventilation ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.

scholarly journals Role of Non-invasive Ventilation in Managing Life-threatening Acute Exacerbation of Interstitial Pneumonia

2010 ◽  
Vol 49 (14) ◽  
pp. 1341-1347 ◽  
Author(s):  
Keisuke Tomii ◽  
Ryo Tachikawa ◽  
Kazuo Chin ◽  
Kimihiko Murase ◽  
Tomohiro Handa ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Interstitial Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Life Threatening

scholarly journals Respiratory Management of Acute Cardiogenic Pulmonary Edema: A Review

2020 ◽  
Author(s):  
Khosro Barkhordari ◽  
Zahid Hussain Khan ◽  
Akbar Shafiee
Keyword(s):  
Pulmonary Edema ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Cardiogenic Pulmonary Edema ◽  
Positive Pressure ◽  
Acute Cardiogenic Pulmonary Edema ◽  
Respiratory Management ◽  
Threatening Condition ◽  
Ventilator Management ◽  
Life Threatening

Acute cardiogenic pulmonary edema (ACPE) is a common and life-threatening condition among patients with heart failure. The literature contains a large number of reviews discussing the respiratory management aspect of this entity; nonetheless, none of these studies has thoroughly probed into the respiratory management of different cardiac pathologies ending with ACPE, together with the different modes of ventilation and invasive and noninvasive ventilation in the same discussion. The present review seeks to discuss the physiologic bases of lung-heart interactions, the hemodynamic effects of positive pressure ventilation, and the results of studies on the effects of the various modes of ventilation having been used until the writing of this article. Also discussed herein are ACPE in different heart pathologies and their respective ventilator management, as well as the indications, complications, and contraindications of noninvasive positive pressure ventilation and intermittent mandatory ventilation.

Role of a Nurse in Non-invasive Positive Pressure Ventilation: A Conceptual Model for Clinical Practice

2013 ◽  
Vol 5 (1) ◽  
pp. 119
Author(s):  
Ramesh Venkatesaperumal ◽  
Melba Sheila D'Souza ◽  
Shreedevi Balachandran ◽  
Jayanthi Radhakrishnan
Keyword(s):  
Clinical Practice ◽  
Conceptual Model ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive

scholarly journals Pneumomediastinum in patients with SARS-CoV-2 treated with non-invasive ventilation

2021 ◽  
Vol 14 (3) ◽  
pp. e241809
Author(s):  
Onn Shaun Thein ◽  
Muhammad Niazi ◽  
Abdisamad Ali ◽  
Adeel Sahal
Keyword(s):  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Best Supportive Care ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Bridging Therapy ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Common Causes ◽  
Poor Outcomes

SARS-CoV-2, causing the pandemic COVID-19, has rapidly spread, overwhelming healthcare systems. Non-invasive positive pressure ventilation (NIV) can be used as a bridging therapy to delay invasive mechanical ventilation or as a standalone therapy. Spontaneous pneumomediastinum is rare and self-limiting, but there is an increased incidence documented in COVID-19.Here we document two cases of pneumomediastinum-related prolonged NIV therapy in severe COVID-19. Patient 1, a 64-year-old man, who developed symptoms after NIV therapy was weaned and survived. Patient 2, an 82-year-old woman, failed to improve despite NIV therapy, on investigation was found to have a pneumomediastinum. After review, the patient was placed on best supportive care and died 3 days later.We highlight the importance of recognising less common causes of deterioration in severe COVID-19 treated with NIV. In addition, pneumomediastinum in these cases may not always lead to poor outcomes.

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