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Recurrent Pneumothorax with CPAP Therapy for Obstructive Sleep Apnea
Kartikeya Rajdev1, Pretty Sara Idiculla2, Shubham Sharma3
1Department of Internal Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, University of Nebraska Medical Center, 42nd and Emile St., Omaha, Nebraska 68198-7400, USA.
Case Reports in Pulmonology
|February 1, 2021
Summary
Continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) can rarely cause pneumothorax (PTX). This case report highlights the risk of pulmonary barotrauma associated with CPAP use in OSA patients.
Area of Science:
- Pulmonology
- Sleep Medicine
- Critical Care Medicine
Background:
- Pulmonary barotrauma, like pneumothorax (PTX), is a recognized complication of invasive mechanical ventilation.
- It is infrequently documented with noninvasive positive pressure ventilation (NPPV) and continuous positive airway pressure (CPAP) therapy.
Observation:
- A 66-year-old female with chronic dyspnea and obstructive sleep apnea (OSA) developed recurrent pneumothorax (PTX) after initiating CPAP therapy.
- The patient experienced three separate PTX events over several months, temporally linked to her CPAP use.
Findings:
- This case report underscores the potential risk of barotrauma, specifically PTX, associated with CPAP therapy for OSA.
- Recurrent PTX in this patient was strongly associated with CPAP initiation, leading to its permanent discontinuation.
Implications:
- Clinicians should be aware of the rare but serious risk of PTX with CPAP use in OSA patients.
- Implementing lung-protective ventilation strategies and optimizing positive airway pressures may mitigate the risk of pulmonary barotrauma during CPAP therapy.
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