A case of subcutaneous emphysema/mediastinal emphysema during the use of humidified high-flow nasal cannula

Autor: Shota Sonobe, Satoki Inoue, Tadashi Nishiwada, Junji Egawa, Masahiko Kawaguchi
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: JA Clinical Reports, Vol 5, Iss 1, Pp 1-3 (2019)
Druh dokumentu: article
ISSN: 2363-9024
DOI: 10.1186/s40981-019-0305-3
Popis: Abstract Background Heated, humidified, high-flow nasal cannula (HHFNC) oxygen therapy allows optimal humidification of inspired gas at high flows and creates a distending pressure similar to nasal continuous positive airway pressure [1]. It has been safely used in adults with moderate hypoxemia with few complications [2, 3]. Hereby, we report serious complications occurred during HHFNC oxygen therapy. Case presentation A 53-year-old female with hemophagocytic lymphohistiocytosis (HLH) was admitted to the intensive care unit because of respiratory failure. After weaning from mechanical ventilation which lasted for 2 weeks, HHFNC therapy at 40 L/min with an FiO2 of 0.5 was started for hypoxemia. Four days later, dyspnea and hypoxemia occurred and chest X-ray and CT scan revealed localized pneumothorax, subcutaneous emphysema, and massive pneumomediastinum. After cessation of HHFNC, respiratory condition improved. Conclusion Subcutaneous emphysema, pneumothorax, and pneumomediastinum should be notified as a serious complication during HHFNC therapy.
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