J Cardiothorac Surg . Expectant management of pneumothorax in intubated COVID-19 positive patients: a case series

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J Cardiothorac Surg


. 2020 Sep 21;15(1):263.
doi: 10.1186/s13019-020-01297-7.
Expectant management of pneumothorax in intubated COVID-19 positive patients: a case series


Colby Elder ¹ , Sheina Bawa ² , Douglas Anderson ² , Stephen Atkinson ³ , Joshua Etzel ³ , Troy Moritz ²



Affiliations

• PMID: 32958067
• DOI: 10.1186/s13019-020-01297-7

Abstract

Background: There is an increasing amount of literature describing the pathogenesis of coronavirus disease 2019 (COVID-19) pneumonia and its associated complications. Historically, a small pneumothorax has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia patients. In addition, pneumothorax in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management.
Case presentation: In this series we report four cases of patients with respiratory distress who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces which were successfully managed with observation alone.
Conclusions: Management of patients with COVID-19 pneumonia on positive pressure ventilation who develop small stable pneumothoraces can be safely observed without chest tube insertion.

Keywords: COVID-19; Case report; Pneumothorax.