en
Scientific article
Case report
Open access
English

Valsalva manoeuvre-induced pneumothorax and pneumomediastinum in a COVID-19 patient with ARDS : an unusual mechanism for this complication

Published inEuropean journal of case reports in internal medicine, vol. 11, no. 3, 004217
Publication date2024-02-28
First online date2024-02-28
Abstract

Background: Until now, only a few cases of Valsalva-induced barotraumas (pneumothorax, pneumomediastinum and subcutaneous emphysema) have been described, and none of them among COVID-19 patients. Case description: A man in his 50s was admitted for SARS-CoV-2-related acute respiratory distress syndrome (ARDS). Initial evolution was favourable with non-invasive ventilatory support, high-flow oxygen nasal cannula and the best supportive drugs available at the time. During the Valsalva manoeuvre while defecating, the patient reported sudden chest pain and showed a new acute hypoxemic respiratory failure due to a pneumothorax. It led to multiple complications (pulmonary embolism, haemoptysis, and cardiac arrest), and despite the best supportive care, led to the patient's death. Discussion: The Valsalva manoeuvre can be an overlooked cause of pneumothorax in patients with COVID-19. Predisposition to barotrauma in COVID-19 patients could be explained by several factors, including the extensive use of non-invasive and invasive ventilation during the pandemic, and the histological changes observed in the lungs of those infected with COVID-19. Conclusion: We report the first description of a Valsalva-induced barotrauma in a COVID-19 infection. We emphasise the importance of treating constipation particularly in severe COVID-19 cases, to prevent complications such as barotrauma.

eng
Keywords
  • COVID-19
  • Valsalva
  • Pneumothorax
Citation (ISO format)
WEERAWARDANE, Totawatte Don Srilak et al. Valsalva manoeuvre-induced pneumothorax and pneumomediastinum in a COVID-19 patient with ARDS : an unusual mechanism for this complication. In: European journal of case reports in internal medicine, 2024, vol. 11, n° 3, p. 004217. doi: 10.12890/2024_004217
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal2284-2594
12views
2downloads

Technical informations

Creation03/02/2024 11:37:41 AM
First validation05/06/2024 7:52:16 AM
Update time05/06/2024 7:52:16 AM
Status update05/06/2024 7:52:16 AM
Last indexation05/06/2024 7:52:38 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack