Covid-19 pneumonia and ventilation-induced lung injury: A case report
Article Category: Original Paper
Published Online: Dec 31, 2020
Page range: 80 - 82
Received: Sep 02, 2020
Accepted: Sep 17, 2020
DOI: https://doi.org/10.2478/rjaic-2020-0020
Keywords
© 2020 Lieke H.A. van Gastel, MD et al. published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
We present the case of a 67-year-old male patient, who was admitted to the intensive care unit for hypoxemic respiratory failure due to severe COVID-19 pneumonitis, requiring mechanical ventilation. Despite close monitoring using transpulmonary pressure measurements and interventions to pursue lung-protective ventilation, the patient developed extensive barotrauma including a right-sided pneumothorax, subcutaneous emphysema and pneumomediastinum while on pressure support ventilation. We hypothesize that the high respiratory drive that COVID-19 patients seem to exhibit, combined with diffuse alveolar injury and increased alveolar pressure, resulted in gross barotrauma.
Conclusion
The respiratory characteristics that COVID-19 patients seem to exhibit might expose those on mechanical ventilation to an increased risk of developing ventilation-induced lung injury. This case emphasizes that caution should be taken in the respiratory treatment of patients with COVID-19 pneumonitis.