Pneumothorax and pulmonary air leaks as ventilator-induced injuries in COVID-19

Abstract

Figure 1. Chest X-ray (A) and computed tomography thoracic scan (B) of a 59-year-old male coronavirus disease 2019 (COVID-19) patient after 3 days of invasive ventilation. Ventilation occurred in pressure-control mode with the following parameters: peak inspiratory pressure, 27 cm H2O; positive end-expiratory pressure, 12 cm H2O; fraction of inspired oxygen, 0.6; inspiratory to expiratory ratio, 1:2; and respiratory rate, 16. The last measurement prior to the occurrence of pneumothorax was a plateau pressure of 25 cm H2O and static compliance of 43 L/cm H2O. Bilateral inhomogeneous parenchyma and consolidative aspects of the left lung were noted. The patient developed left pneumothorax and pneumomediastinum. On chest X-ray, subcutaneous emphysema is evident.