Incidence of Surgical Emphysema and Pneumothorax in Ventilated COVID-19 Patients versus Other Respiratory Disease | ||
International Journal of Medical Arts | ||
Articles in Press, Accepted Manuscript, Available Online from 01 October 2025 | ||
Document Type: Original Article | ||
DOI: 10.21608/ijma.2025.405760.2268 | ||
Authors | ||
Gamal Abdelshafy Farag* 1; Rezk Zenhom Abogamela2; Ibrahim Fathi Abou Elfetouh3 | ||
1Cardiothoracic surgery department Faculty of medicine Al-Azhar university Damietta | ||
2Department of Cariothoracic Surgery, Faculty of Medicine (For Girls), Al-Azhar University, Cairo, Egypt. | ||
3Department of Chest Diseases, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. | ||
Abstract | ||
Background: Surgical emphysema and pneumothorax are known complications of mechanical ventilation, often resulting from increased intra-alveolar pressure due to underlying disease severity or invasive procedures such as intubation, central line placement, or chest tube insertion. COVID-19 has been associated with diffuse alveolar damage, which may increase the risk of these complications in ventilated patients Aim: this study aimed to compare the incidence of surgical emphysema and pneumothorax in mechanically ventilated COVID-19 patients with those ventilated for other respiratory diseases Patients and methods: This retrospective observational study was conducted at Security Forces Hospital (SFH), Riyadh, KSA, from April 2020 to July 2021. Eighty patients admitted to the intensive care unit and requiring mechanical ventilation were enrolled. They were divided into two groups: 40 patients ventilated for COVID-19 and 40 patients ventilated for other respiratory conditions. Medical records and imaging studies were reviewed to identify cases of surgical emphysema and pneumothorax Results: The incidence of surgical emphysema and pneumothorax was significantly higher in the COVID-19 group compared to the non-COVID group. COVID-19 patients showed more extensive subcutaneous emphysema and a higher need for chest tube insertion. The findings suggest a correlation between COVID-19-associated lung pathology and an increased risk of ventilation-related barotrauma Conclusion: Mechanically ventilated COVID-19 patients are at a significantly greater risk of developing surgical emphysema and pneumothorax compared to patients ventilated for other respiratory illnesses. This highlights the importance of early detection, close monitoring, and preventive ventilatory strategies in this high-risk population. | ||
Keywords | ||
Surgical emphysema; Pneumothorax; COVID-19 | ||
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