Pneumatocele and mediastinal emphysema preceding bilateral pneumothorax during airway pressure release ventilation

Posted On 2020-08-21 09:38:43

A 52-year-old lady was admitted to the intensive care unit (ICU) with decompensated dilated cardiomyopathy requiring a Dobutamine infusion via a right internal jugular central venous catheter (CVC).

Her CVC was removed once her cardiac function stabilised. Over the next hour, she reported light-headedness, neck and shoulder pain and her blood pressure dropped from 96/61 to 72/43 mmHg. Her haemoglobin dropped from 112 to 77 g/L over the next four hours. Her coagulation profile was normal. An ultrasound showed no evidence of a neck haematoma.

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