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[Pneumomediastinum and cocaine use]
Michel Underner1, Jean Perriot2, Gérard Peiffer3
1Centre hospitalier Henri-Laborit, unité de recherche clinique, 86000 Poitiers, France.
Presse Medicale (Paris, France : 1983)
|February 13, 2017
Summary
Cocaine use, particularly smoking, can cause spontaneous pneumomediastinum, a condition presenting with sudden chest pain. This respiratory disorder in young individuals typically resolves within days, highlighting the need to consider cocaine use in diagnosis.
Area of Science:
- Respiratory Medicine
- Toxicology
- Public Health
Background:
- Cocaine is a prevalent illicit drug in France, associated with various respiratory issues.
- Pneumomediastinum is a recognized, albeit less common, respiratory complication of cocaine use.
Purpose of the Study:
- To systematically review and synthesize existing literature on pneumomediastinum in individuals who use cocaine.
- To identify the clinical presentation, characteristics, and outcomes of cocaine-induced pneumomediastinum.
Main Methods:
- A systematic literature search was conducted using Medline from 1980 to 2016.
- Keywords included "pneumomediastinum" combined with "cocaine" or related terms, limited to English and French articles.
- 37 studies were selected after reviewing 72 articles and 48 abstracts.
Main Results:
- The review identified 44 cases, predominantly in young males (age 15-36), with smoking (crack or free-base) being a common route of administration.
- The most frequent symptom was sudden onset chest pain, often with neck discomfort, dyspnea, or cough.
- Most cases of isolated pneumomediastinum resolved spontaneously within 1-4 days.
Conclusions:
- Spontaneous pneumomediastinum can be a direct consequence of cocaine use.
- Clinicians should consider cocaine use in young patients presenting with pneumomediastinum and sudden chest pain.
- Encouraging cessation of cocaine use is crucial for managing this condition.