Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges

  • Ahmed Khedher Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Khaoula Meddeb Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Nesrine Sma Medical intensive care unit of Farhat Hached Hospital, Sousse Tunisia
  • Abdelbaki Azouzi Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Nesrine Fraj Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia
  • Mohamed Boussarsar Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia

Keywords

Pulmonary interstitial emphysema, status asthmaticus, barotrauma, mechanical ventilation

Abstract

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described.

Patient: We describe the case of a 64-year-old man who presented with huge pulmonary interstitial emphysema together with simultaneous pulmonary barotrauma in status asthmaticus requiring invasive ventilation.

Discussion: There are no guidelines for the management of such complications and their possible sequelae but conservative treatment seems to be effective. The treatment of our patient is described.

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References

  • Marini JJ. Ventilator-associated problems related to obstructive lung disease. Resp Care 2013;58:938–949.

  • Al-Abdi SY, Singhal N. Pulmonary interstitial emphysema and continuous positive airway pressure in a premature infant. Saudi Med J 2005;26:1627–1629.

  • Donnelly LF, Lucaya J, Ozelame V, Frush DP, Strouse PJ, Sumner TE, et al. CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. Am J Roentgenol 2003;180:1129–1133.

  • Unger JM, England DM, Bogust GA. Interstitial emphysema in adults: recognition and prognostic implications.J Thorac Imaging1989;4:86–94.

  • Schwartz AN, Graham CB. Neonatal tension pulmonary interstitial emphysema in bronchopulmonary dysplasia: treatment with lateral decubitus positioning. Radiology 1986;161:351–354.

  • Chalak LF, Kaiser JR, Arrington RW. Resolution of pulmonary interstitial emphysema following selective left main stem intubation in a premature newborn: an old procedure revisited. Paediatr Anaesth 2007;17:183–186.

  • Matta R, Matta J, Hage P, Nassif Y, Mansour N, Diab N. Diffuse persistent interstitial pulmonary emphysema treated by lobectomy. Ann Thorac Surg 2011;92:73–75.
  • Published: 2018-03-02

    Issue: Vol 5 No 5 (view)

    Section: Articles

    How to cite:
    Khedher, A., Meddeb, K., Sma, N., Azouzi, A., Fraj, N., & Boussarsar, M. (2018). Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges. European Journal of Case Reports in Internal Medicine, 5(5). https://doi.org/https://doi.org/10.12890/2018_000823

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