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Acute ventilatory failure from massive subcutaneous emphysema

R Conetta1, A A Barman, C Iakovou

  • 1Department of Medicine, Flushing Hospital Medical Center, NY 11355.

Chest
|September 1, 1993
PubMed
Summary
This summary is machine-generated.

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Massive subcutaneous emphysema after intubation caused life-threatening respiratory acidosis. Emergency tracheostomy successfully decompressed the patient, resolving the condition and proving life-saving.

Area of Science:

  • Medicine
  • Pulmonology
  • Critical Care

Background:

  • Subcutaneous emphysema, the presence of air in subcutaneous tissues, can arise from various medical procedures.
  • Positive pressure ventilation, often used during intubation, can increase the risk of air dissection into tissues.

Observation:

  • A 66-year-old female patient developed extensive subcutaneous emphysema following endotracheal intubation.
  • This led to acute thoracic restriction and severe respiratory acidosis, rendering conventional ventilation ineffective.

Findings:

  • The patient experienced life-threatening ventilatory failure due to the massive subcutaneous emphysema.
  • Surgical decompression via tracheostomy was performed to relieve pressure on the chest and mediastinum.

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Implications:

  • Tracheostomy provided rapid resolution of the respiratory compromise.
  • This case highlights tracheostomy as a potentially life-saving intervention for severe, procedure-induced subcutaneous emphysema and ventilatory failure.