Tension pneumothorax in a patient with COVID-19
Tension pneumothorax in a patient with COVID-19
复制标题
DOI：
10.1136/bcr-2020-235861
复制
发表时间：
2020-05-01
期刊：
影响因子：
0.9
通讯作者：
Henry, Alun Marc
中科院分区：
文献类型：
--
作者：
Flower, Luke;Carter, John-Paul L.;Henry, Alun Marc
一名36岁男子因疑似COVID-19被送往急诊室，此前有3周的咳嗽、发烧和呼吸急促病史，在前4小时突然恶化。就诊时，患者出现低氧血症，SpO（2）为88%，氧浓度为15 L/min，心动过速，左半胸听诊时听不到呼吸音。当地指南建议，在等待检查期间，患者应开始持续气道正压通气，但鉴于检查结果，进行了紧急便携式胸片检查。胸片显示左侧张力性气胸。经急诊针吸减压，效果良好，后行胸腔置管引流。复查胸片显示肺复张，患者入住COVID-19专用病房进行进一步观察。此病例证明张力性气胸是疑似COVID-19的可能并发症，并强调了全面病史采集和临床检查的重要性。
A 36-year-old man was brought to the emergency department with suspected COVID-19, following a 3-week history of cough, fevers and shortness of breath, worsening suddenly in the preceding 4hours. On presentation he was hypoxaemic, with an SpO(2) of 88% on 15L/min oxygen, tachycardic and had no audible breath sounds on auscultation of the left hemithorax. Local guidelines recommended that the patient should be initiated on continuous positive airway pressure while investigations were awaited, however given the examination findings an emergency portable chest radiograph was performed. The chest radiograph demonstrated a left-sided tension pneumothorax. This was treated with emergency needle decompression, with good effect, followed by chest drain insertion. A repeat chest radiograph demonstrated lung re-expansion, and the patient was admitted to a COVID-19 specific ward for further observation. This case demonstrates tension pneumothorax as a possible complication of suspected COVID-19 and emphasises the importance of thorough history-taking and clinical examination.