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Subconjunctival emphysema as a complication of PEEP
Annals of Ophthalmology
|September 1, 1980
Summary
Subconjunctival emphysema occurred in a child receiving mechanical ventilation with high positive expiratory pressure (PEEP). This condition resolved when PEEP was reduced, highlighting PEEP
Area of Science:
- Pediatric Critical Care Medicine
- Ophthalmology
- Trauma Surgery
Background:
- Mechanical ventilatory support is crucial for critically ill patients.
- High positive expiratory pressure (PEEP) can lead to barotrauma.
- Subconjunctival emphysema is a rare complication of positive pressure ventilation.
Observation:
- A four-year-old girl developed subconjunctival emphysema after a motor vehicle accident.
- Air collection occurred in the conjunctiva, presenting as a ballooning.
- The emphysema was crepitant and reducible with gentle pressure.
Findings:
- The subconjunctival emphysema persisted during high PEEP ( > 18 cm H2O).
- The condition resolved completely after PEEP was decreased ( < 5 cm H2O).
- This case demonstrates a direct correlation between PEEP levels and subconjunctival emphysema.
Implications:
- Careful monitoring of PEEP is essential in pediatric patients.
- Subconjunctival emphysema may indicate underlying barotrauma.
- Management strategies should consider PEEP reduction for resolution.