Endobronchial valve positioning for alveolar-pleural fistula following ICU management of severe COVID-19 pneumonia
| Autor: | Donatelli, Pierluigi, Trenatacosti, Fabiana, Pellegrino, Maria Rosaria, Tonelli, Roberto, Bruzzi, Giulia, Andreani, Alessandro, Cappiello, Gaia Francesca, Andrisani, Dario, Gozzi, Filippo, Mussini, Cristina, Busani, Stefano, Cavaliere, Gilda Valentina, Girardis, Massimo, Bertellini, Elisabetta, Clini, Enrico, Marchioni, Alessandro |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
RC705-779 SARS-CoV-2 COVID-19 Pneumothorax Correction Case Report COVID19 bronchopleural fistula alveolar-pleural fistula endobronchial valve Pleural Diseases Respiration Artificial respiratory tract diseases Klebsiella pneumoniae Diseases of the respiratory system Intensive Care Units Bronchoscopy Humans Bronchial Fistula Respiratory Tract Fistula Endobronchial valve Tomography X-Ray Computed Alveolar-pleural fistula Aged |
| Zdroj: | BMC Pulmonary Medicine BMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-6 (2021) |
| Popis: | Background The main clinical consequences of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are pneumonia and respiratory failure even requiring mechanical ventilation. In this context, the lung parenchyma is highly prone to ventilator-related injury, with pneumothorax and persistent air leak as the most serious adverse events. So far, endobronchial valve (EBV) positioning has proved efficacious in treating air leaks with a high success rate. Case presentation We report, for the first time, two cases of patients affected by SARS-CoV-2-related pneumonia complicated with bacterial super-infection, experiencing pneumothorax and persistent air leaks after invasive mechanical ventilation. Despite the severity of respiratory failure both patients underwent rigid interventional bronchoscopy and were successfully treated through EBV positioning. Conclusions Persistent air leaks may result from lung tissue damage due to a complex interaction between inflammation and ventilator-related injury (VILI), especially in the advanced stages of ARDS. EBV positioning seems to be a feasible and effective minimally invasive therapeutic option for treating this subset of patients. |
| Databáze: | OpenAIRE |
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