Open AccessPneumomediastinum secondary to invasive and non-invasive mechanical ventilation
Author(s) -
Sara Mousa,
Hawa Edriss
Publication year - 2019
Publication title -
the southwest respiratory and critical care chronicles
Language(s) - English
Resource type - Journals
ISSN - 2325-9205
DOI - 10.12746/swrccc.v7i27.524
Subject(s) - pneumomediastinum , medicine , mechanical ventilation , ventilation (architecture) , tidal volume , mediastinum , incidence (geometry) , respiratory distress , anesthesia , complication , acute respiratory distress , lung , surgery , respiratory system , mechanical engineering , engineering , physics , optics
Pneumomediastinum (PM) is defined as the presence of abnormal gas in the mediastinum.It is a known complication of invasive mechanical ventilation and has been reported withnon-invasive ventilation. Recent studies have reported that the incidence of barotrauma islowest in post-operative patients and is highest in mechanically ventilated patients with acuterespiratory distress syndrome. The incidence has dropped with the low tidal volume ventilationtechnique. Chest x-rays can miss up to 25% of small PMs detected by computed tomographyscans of the chest. Pneumomediastinum is managed with low tidal volume ventilation withplateau pressures <30 cm H2O and treatment of the underlying lung disease. Novel ways ofventilation, such as high frequency oscillatory ventilation and asynchronous independent lungventilation, may improve ventilation in some patients.