title: Pneumomediastinum complicated by subclavian central venous catheterization in a severe thoracic trauma patient.
abstract: Pneumomediastinum is a rare event in subclavian central venous catheterization. However in severe thoracotraumatized patients, such as with bilateral hemopneumothorax, the catherization may be hazardous and made complex by occurrence pneumomediastinum, even the procedure is rightly carried out. We suggest that in such a risky condition, if it is mandatory, it should be carried out in a more placid condition, such as avoidance of high PEEP ventilation, setting lower tidal volume, or brief interruption of positive ventilation, to reduce the likelihood of unperceivable pneumomediastinum.
authors.affiliation: Department of Anesthesiology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Liang-Chih
authors.initials: LC
authors.lastname: Chen
authors.forename: Chi
authors.initials: C
authors.lastname: Tzao
authors.forename: Wen-Jinn
authors.initials: WJ
authors.lastname: Liaw
authors.forename: Huei-Chi
authors.initials: HC
authors.lastname: Horng
authors.forename: Chen-Hwan
authors.initials: CH
authors.lastname: Cherng
authors.forename: Chih-Shung
authors.initials: CS
authors.lastname: Wong
authors.forename: Ching-Tang
authors.initials: CT
authors.lastname: Wu
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology*; D011175:Positive-Pressure Respiration; D013902:Radiography, Thoracic; D013350:Subclavian Vein; D013898:Thoracic Injuries / Q000601:surgery*