Secondary Pneumomediastinum Following Bronchoscopic Interventions in Patients With Prolonged Tracheostomy Intubation: A Case Series
Abstract
Case series Patients: Mele, 38-year-old • Mele, 69-year-old • Mele, 19-year-old Final Diagnosis: Prolonged tracheostomy intubation Symptoms: A severe cough • shortness of breath • subcutaneous emphysema Clinical Procedure: Anti-infection • closed chest drainage • cough suppression • subcutaneous incision Specialty: Critical Care Medicine • Rehabilitation Objective: Rare coexistence of disease or pathology Background Tracheostomy is a cornerstone of long-term intensive care, utilized in approximately 15% of intensive care unit patients. While beneficial, prolonged tracheostomy intubation initiates structural changes within the tracheal architecture, predisposing patients to severe late-stage complications, including secondary pneumomediastinum, which can rapidly progress to tension physiology and obstructive shock. Specific triggers, pathophysiological pathways (eg Macklin effect vs direct disruption), and multi-compartment air tracking in tracheostomized populations remains incompletely understood. This report seeks to guide early prevention and emergency management by describing chronological clinical presentations, diagnostic decision-making, and therapeutic outcomes of complications in 3 prolonged-tracheostomy patients. Case Reports Three male patients underwent prolonged tracheostomy intubation (>1 month) and developed pneumomediastinum following airway manipulation. A 38-year-old patient developed severe subcutaneous emphysema (SE) 48 hours post-decannulation following…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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