Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus.
A 12-year-old male with status asthmaticus developed subcutaneous emphysema and pneumomediastinum. He was transferred to our unit, where he received noninvasive ventilation (NIV). This respiratory support technique is not an absolute contraindication in these cases. After 2 h on NIV, he worsened sharply and the subcutaneous emphysema got bigger suddenly. He needed invasive ventilation for 5 days. Final outcome was satisfactory. This case illustrates that it is mandatory to keep a high level of vigilance when using NIV in patients with air leaks.
Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Lara
L
González García
Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Corsino
C
Rey
Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Alberto
A
Medina
Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Juan
J
Mayordomo-Colunga
Asthma; noninvasive ventilation; pneumomediastinum; subcutaneous emphysema