Comparison of treatments proved difficult and it was concluded that, although most cases would probably respond satisfactorily to 2.8 bar (2100 mm Hg) of oxygen, there were no compelling reasons for altering the current treatment practice of beginning treatment of acute cases with a 30-min period at 6.0 bar (165 fsw) before returning to 2.8 bar (60 fsw) to complete the therapy. Increasing the time to treatment reduced the likelihood of cure. The remaining cures occurred in equal numbers during decompression and after surfacing. An overall success rate of 65% was seen with 62% of cures occurring within 25 min of arrival at pressure. The 89 treated cases of AGE (including 2 iatrogenic cases) were used to study the efficacy of different treatments. Half of AGE cases improved spontaneously, including 21% which recovered completely. Details of presentation and precipitating factors were analysed. There were 23 cases of uncomplicated PBT and 117 cases of cerebral arterial gas embolism (AGE), of which 58 had respiratory manifestations. 2013 Jun 110(6):896-914.A review of case records spanning 20 years revealed 140 cases of decompression pulmonary barotrauma (PBT) in divers. Complications of non-invasive ventilation techniques: a comprehensive qualitative review of randomized trials. 2002 Apr 01 165(7):978-82.Ĭarron M, Freo U, BaHammam AS, Dellweg D, Guarracino F, Cosentini R, Feltracco P, Vianello A, Ori C, Esquinas A. 2002 Apr 28(4):406-13.Įisner MD, Thompson BT, Schoenfeld D, Anzueto A, Matthay MA, Acute Respiratory Distress Syndrome Network Airway pressures and early barotrauma in patients with acute lung injury and acute respiratory distress syndrome. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. 1994 Jun 08 271(22):1772-9.īoussarsar M, Thierry G, Jaber S, Roudot-Thoraval F, Lemaire F, Brochard L. Lung structure and function in different stages of severe adult respiratory distress syndrome. Gattinoni L, Bombino M, Pelosi P, Lissoni A, Pesenti A, Fumagalli R, Tagliabue M. Ioannidis G, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Lampaki S, Kioumis I, Pitsiou G, Papaiwannou A, Karavergou A, Katsikogiannis N, Sarika E, Tsakiridis K, Korantzis I, Zarogoulidis K, Zarogoulidis P. Patients at high risk of developing barotrauma from mechanical ventilation include individuals with predisposing lung pathology such as chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD), pneumocystis jiroveci pneumonia, and acute respiratory distress syndrome (ARDS).Ĭopyright © 2023, StatPearls Publishing LLC. The incidence of barotrauma in patients receiving non-invasive mechanical ventilation is much lower when compared to patients receiving invasive mechanical ventilation. Keywords Barotrauma Diving Ear Para-nasal sinuses Pneumothorax Embolism Air Hyperbaric oxygenation Introduction Barotrauma is pressure-induced injury. Mechanical ventilation modalities include invasive mechanical ventilation and non-invasive mechanical ventilation, such as bilevel positive airway pressure. The management of these problems includes prevention, the use of pressure-equalising techniques, vasoconstrictor drugs, surgery, and hyperbaric oxygen therapy. Excess alveolar air could then result in complications such as pneumothorax, pneumomediastinum, and subcutaneous emphysema. The patient reported in this work deteriorated following pulmonary barotrauma. Barotrauma is most commonly due to alveolar rupture, which leads to an accumulation of air in extra alveolar locations. PMID: 1763619 DOI: 10.3109/00016349109007171 Abstract Air embolism may occur following criminal abortion, vaginal douching, powder insufflation as treatment for vaginal infections, and orogenital sex. Pulmonary barotrauma is the presence of extra alveolar air in locations where it is not present under normal circumstance. Since positive pressure ventilation is not physiological, it may lead to complications such as barotrauma. It is also called ear, sinus, lung, or gut squeeze. It can also affect your lungs, stomach, or intestines. You may have an injury to your ears, sinuses, or teeth. In contrast, patients on mechanical ventilation ventilate with positive pressures. Treatment What is barotrauma Barotrauma is an injury to your body caused by a pressure change. The natural mechanism of breathing in humans depends on negative intrathoracic pressures. Pulmonary barotrauma is a complication of mechanical ventilation and has correlations with increased morbidity and mortality. This article will focus on pulmonary barotrauma. The most common organs affected by barotrauma are the middle ear (otic barotrauma), sinuses (sinus barotrauma), and the lungs (pulmonary barotrauma). Barotrauma is commonly observed in scuba divers, free-divers, or even in airplane passengers during ascent and descent. Barotrauma is damage to body tissue secondary to pressure difference in enclosed cavities within the body.
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