title: Biphasic cuirass ventilation for treatment of an air leak after pneumothorax in a patient with nemaline myopathy: a case report.
abstract: We describe an 11-year-old boy with nemaline myopathy who developed tension pneumothorax while undergoing noninvasive positive-pressure ventilation (NIPPV). The patient developed a persistent air leak after pleurodesis with minocycline hydrochloride and lowering of the NIPPV inspiratory pressure. He required additional respiratory support without the high airway pressures that may aggravate pneumothorax. We provided adequate respiratory support without increasing the positive airway pressure using biphasic cuirass ventilation (BCV), which moved the patient's chest wall by negative pressure. The air leak was resolved without any additional treatment. We should provide BCV for patients in whom surgery may have a risk of both extubation failure and postoperative complications before deciding on surgery.
authors.affiliation: Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. hitomihi@m.ehime-u.ac.jp.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Hino
authors.affiliation: Department of Pediatrics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishii
authors.affiliation: Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Fukuda
mesh_terms: D060666:Airway Extubation / Q000009:adverse effects; D002648:Child; D006801:Humans; D008297:Male; D008911:Minocycline / Q000008:administration & dosage; D017696:Myopathies, Nemaline / Q000628:therapy*; D011030:Pneumothorax / Q000209:etiology*; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology
chemical_list: D008911:Minocycline
keywords: Neurology; Pediatrics; Pneumothorax; Ventilation