Spontaneous pneumomediastinum in Covid-19 : a case of complete resolution despite invasive positive pressure ventilation


Spontaneous pneumomediastinum ; covid-19 ; lung protective ventilation ; patient self-inflicted lung injury ; case report

Published online: Mar 28 2022


M. Wolfskeil (*), Y. Devriendt (*), A. Dumoulin (*), P. Lormans (*)

Department of Anesthesiology and Intensive Care, AZ Delta, Roeselare, Belgium


We present the case of a 65-year-old patient who was admitted to the intensive care unit (ICU) due to Covid-19 respiratory failure. During his hospital stay, he developed a spontaneous pneumomediastinum (SP). To date, there have been few reports of SP associated with Covid-19 and even less is known about the impact of positive pressure ventilation on these patients.

Our patient was first treated with high-flow nasal cannula oxygen therapy (HFNC). Because of further respiratory deterioration, he was supported with non-invasive ventilation (NIV). Later, he required intubation and ventilation with invasive positive pressure ventilation. Despite this, a complete spontaneous resolution of the pneumomediastinum was observed 13 days after the initial diagnosis.