title: Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome.
abstract: Spontaneous pneumomediastinum (SP) unrelated to assisted ventilation is a newly recognised complication of severe acute respiratory syndrome (SARS). The objective of the present study was to examine the incidence, risk factors and the outcomes of SP in a cohort of SARS victims from a community outbreak. Data were retrieved from a prospectively collected database of virologically confirmed SARS patients. One hundred and twelve cases were analysable, with 13 patients developing SP (11.6%) at a mean +/- SD of 19.6 +/- 4.6 days from symptom onset. Peak lactate dehydrogenase level was associated with the development of SP. SP was associated with increased intubation and a trend towards death. Drainage was required in five cases. For patients who survived, the SP and/or the associated pneumothoraces took a median of 28 days (interquartile range: 15-45 days) to resolve completely. In conclusion, spontaneous pneumomediastinum appeared to be a frequent complication of severe acute respiratory syndrome. Further research is needed to investigate its pathogenesis.
authors.affiliation: Dept of Medicine, United Christian Hospital, Hong Kong SAR, China. nncmchu@netvigator.com
authors.forename: C M
authors.initials: CM
authors.lastname: Chu
authors.forename: Y Y
authors.initials: YY
authors.lastname: Leung
authors.forename: J Y H
authors.initials: JY
authors.lastname: Hui
authors.forename: I F N
authors.initials: IF
authors.lastname: Hung
authors.forename: V L
authors.initials: VL
authors.lastname: Chan
authors.forename: W S
authors.initials: WS
authors.lastname: Leung
authors.forename: K I
authors.initials: KI
authors.lastname: Law
authors.forename: C S
authors.initials: CS
authors.lastname: Chan
authors.forename: K S
authors.initials: KS
authors.lastname: Chan
authors.forename: K Y
authors.initials: KY
authors.lastname: Yuen
mesh_terms: D000328:Adult; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed