Respir Case Rep. 2021; 10(1): 8-11 | DOI: 10.5505/respircase.2021.58224

Aðýr COVID-19 Pnömonisinde Spontan Pnömotoraks: Giriþimsel Tedavi ve Bulaþma Riski

Mia Elhidsi, Prasenohadi Prasenohadi, Dicky Soehardiman
Pulmoner Müdahale ve Akciðer Acil Servisi, Göðüs Hastalýklarý ve Solunum Týbbý Bölümü, Týp Fakültesi, Universitas Endonezya - Persahabatan Ulusal Solunum Yönlendirme Hastanesi, Cakarta, Endonezya

Aðýr Akut Solunum Sendromu Corona Virüs 2 (SARS-CoV2) veya Corona Virüs Hastalýðý 2019 (COVID-19), yüksek bulaþýcýlýðý olan ve hýzla yayýlan bir hastalýktýr. Pnömoni sýk görülürken, pnömotoraks gibi plevral boþluðun tutulumu nadir olarak meydana gelir. Pnömotoraks hemen bir toraks tüpü takýlmasýný gerektirir. Torakostomi iþlemleri hassas ve hýzlý bir yönetim gerektir, ancak bulaþma riskinden kaçýnmak için dikkat edilmelidir. Acil servise nefes darlýðý ve oksijen desatürasyonu ile gelen 49 yaþýndaki bir erkek hastayý sunuyoruz. Fizik muayene ve portabl akciðer grafisinde solda pnömotoraks saptandý. Hastaya trakeal entübasyonu takiben toraks tüpü takýldý ve iþlem sonrasý iki saatte akciðerler ekspanse oldu. N95 maskeleri, tam göz korumasý, yüz siperi ve sývýya dayanýklý önlük dahil kiþisel koruyucu ekipman (PPE) giyen iki cerrah iþlemi yaptý. Toraks tüpü takýlmasýndan iki hafta sonar cerrahlarýn SARS-Cov2 PCR testleri negatif olarak geldi. Bu yazýda, konu ile ilgili güncel literatürlerle mevcut bulgular tartýþýldý.

Anahtar Kelimeler: pnömotorkas, COVÝD 19, toraks tüpü, torakostomi, bulaþma riski

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Spontaneous Pneumothorax in Severe COVID-19 Pneumonia: Interventional Treatment and Risk of Transmission

Mia Elhidsi, Prasenohadi Prasenohadi, Dicky Soehardiman
Division of Pulmonary Intervention and Pulmonary Emergency, the Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia - Persahabatan National Respiratory Referral Hospital, Jakarta, Indonesia.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2), or Coronavirus disease 2019 (COVID-19), is a highly contagious and rapidly-spreading disease. While pneumonia is a common finding, pleural space involvement, such as pneumothorax, occurs only in rare cases. Pneumothorax requires the immediate insertion of a chest tube. Thoracostomy procedures require prompt and precise management, but with caution to avoid the risk of transmission. We report here on a 49-year-old male patient who was admitted to the emergency ward with shortness of breath and oxygen desaturation. A physical examination and portable chest X-ray indicated a left pneumothorax. The patient underwent tracheal intubation followed by chest tube insertion, and the lungs inflated two hours after the procedure. The operators included two people, wearing personal protective equipment (PPE), including N95 masks, full eye protection, a face shield and a fluid-resistant gown. Two weeks following chest tube insertion, the operators underwent a SARS-CoV2 PCR examination, with negative results. This report discusses relevant findings in literature related to the current issue.

Keywords: pneumothorax, COVID19, chest tube, thoracostomy, risk of transmission

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ATIF KOPYALA