Chest
Selected ReportsAcute Ventilatory Failure From Massive Subcutaneous Emphysema
Section snippets
CASE REPORT
A 66-year-old woman with a history of seizure disorder was brought to the emergency department after an episode of tonic-clonic seizures at home. At the scene, the emergency medical service found her in a grand mal seizure that responded to 5 mg of intravenous diazepam. She was intubated orally by the ambulance team with an 8-mm endotracheal tube without difficulty. Within 1 h of arrival at the hospital, she became alert and responsive with a blood pressure of 152/108 mm Hg. Bilateral rhonchi
DISCUSSION
Subcutaneous emphysema is not an unusual complication of positive pressure ventilation. Most commonly it arises from airway trauma either at the time of intubation or when high airway pressures result in alveolar rupture and escape of gas into the interstitial space. The free gas can travel along fascial planes and enter the soft tissues. Usually, subcutaneous emphysema is only a cosmetic problem and does not have any serious pathophysiologic sequelae.1
This case illustrates a very unusual
References (2)
- et al.
Subcutaneous and mediastinal emphysema
Arch Intern Med
(1984) - et al.
Pneumatic chest wall compression: a cause of respiratory failure from massive subcutaneous emphysema
Chest
(1991)