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Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation

Patient: Female, 64-year-old Final Diagnosis: Subcutaneous emphysema following open tracheostomy during tracheostomy mask ventilation Symptoms: Shortness of breath • wheeze Medication: — Clinical Procedure: — Specialty: Anesthesiology • Critical Care Medicine OBJECTIVE: Unusual clinical course BACKG...

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Detalles Bibliográficos
Autores principales: Alshoubi, Abdalhai, Mathews, Archana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9465497/
https://www.ncbi.nlm.nih.gov/pubmed/36065149
http://dx.doi.org/10.12659/AJCR.937102
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author Alshoubi, Abdalhai
Mathews, Archana
author_facet Alshoubi, Abdalhai
Mathews, Archana
author_sort Alshoubi, Abdalhai
collection PubMed
description Patient: Female, 64-year-old Final Diagnosis: Subcutaneous emphysema following open tracheostomy during tracheostomy mask ventilation Symptoms: Shortness of breath • wheeze Medication: — Clinical Procedure: — Specialty: Anesthesiology • Critical Care Medicine OBJECTIVE: Unusual clinical course BACKGROUND: Tracheostomy is a surgical procedure that is done by creating an ostomy in the anterior wall of the trachea to facilitate airway access and ventilation. It is indicated for acute respiratory failure after prolonged intubation, upper airway obstruction, difficult airway, and extensive secretions. Early perioperative complications include bleeding, pneumothorax/pneumomediastinum from a false tract, sub-cutaneous emphysema, esophageal perforation, and tracheal ring fractures. CASE REPORT: We present the case of a 64-year-old woman with a past medical history of hypertension, asthma, alcohol and cocaine abuse, bipolar, and, right breast cancer that was treated by chemotherapy and total mastectomy. She was diagnosed with adductor spasmodic dysphonia of unknown etiology 6 months ago and has been treated with Botulinum toxin injection, with an incomplete resolution. She was admitted to the Respiratory Intensive Care Unit with acute hypoxic respiratory failure associated with stridor secondary to laryngospasm, which was unresponsive to steroids and racemic epinephrine. She underwent an emergent open tracheostomy with a regular nonfenestrated tracheostomy tube. A few hours after surgery, she was weaned from mechanical ventilation to a tracheostomy mask oxygen and had an episode of strong cough followed by extensive neck and facial subcutaneous emphysema. CONCLUSIONS: Subcutaneous emphysema is a rare complication but it can be catastrophic, especially if it is associated with pneumothorax and/or pneumomediastinum. Avoiding tight a tracheostomy tube strap and fenestrated tracheostomy tube is one of the measures that can be used to avoid this complication.
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spelling pubmed-94654972022-09-26 Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation Alshoubi, Abdalhai Mathews, Archana Am J Case Rep Articles Patient: Female, 64-year-old Final Diagnosis: Subcutaneous emphysema following open tracheostomy during tracheostomy mask ventilation Symptoms: Shortness of breath • wheeze Medication: — Clinical Procedure: — Specialty: Anesthesiology • Critical Care Medicine OBJECTIVE: Unusual clinical course BACKGROUND: Tracheostomy is a surgical procedure that is done by creating an ostomy in the anterior wall of the trachea to facilitate airway access and ventilation. It is indicated for acute respiratory failure after prolonged intubation, upper airway obstruction, difficult airway, and extensive secretions. Early perioperative complications include bleeding, pneumothorax/pneumomediastinum from a false tract, sub-cutaneous emphysema, esophageal perforation, and tracheal ring fractures. CASE REPORT: We present the case of a 64-year-old woman with a past medical history of hypertension, asthma, alcohol and cocaine abuse, bipolar, and, right breast cancer that was treated by chemotherapy and total mastectomy. She was diagnosed with adductor spasmodic dysphonia of unknown etiology 6 months ago and has been treated with Botulinum toxin injection, with an incomplete resolution. She was admitted to the Respiratory Intensive Care Unit with acute hypoxic respiratory failure associated with stridor secondary to laryngospasm, which was unresponsive to steroids and racemic epinephrine. She underwent an emergent open tracheostomy with a regular nonfenestrated tracheostomy tube. A few hours after surgery, she was weaned from mechanical ventilation to a tracheostomy mask oxygen and had an episode of strong cough followed by extensive neck and facial subcutaneous emphysema. CONCLUSIONS: Subcutaneous emphysema is a rare complication but it can be catastrophic, especially if it is associated with pneumothorax and/or pneumomediastinum. Avoiding tight a tracheostomy tube strap and fenestrated tracheostomy tube is one of the measures that can be used to avoid this complication. International Scientific Literature, Inc. 2022-09-06 /pmc/articles/PMC9465497/ /pubmed/36065149 http://dx.doi.org/10.12659/AJCR.937102 Text en © Am J Case Rep, 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Alshoubi, Abdalhai
Mathews, Archana
Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title_full Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title_fullStr Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title_full_unstemmed Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title_short Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation
title_sort subcutaneous emphysema following open tracheostomy during tracheostomy mask ventilation
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9465497/
https://www.ncbi.nlm.nih.gov/pubmed/36065149
http://dx.doi.org/10.12659/AJCR.937102
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