A 48-year-old woman on ICU develops a pneumomediastinum while on high-PEEP ventilation for ARDS. CXR confirms air in the mediastinum but no pneumothor...

Question

A 48-year-old woman on ICU develops a pneumomediastinum while on high-PEEP ventilation for ARDS. CXR confirms air in the mediastinum but no pneumothorax. She is haemodynamically stable. What is the most appropriate management?

Accepted Answer

Conservative management with close observation, reduce PEEP and airway pressures if possible, chest drain insertion is not routinely required for isolated pneumomediastinum

Answer

Emergency thoracotomy

Answer

Bilateral chest drains prophylactically

Answer

Immediate intubation with a larger ETT

Answer

CT-guided mediastinal drainage

uk-fficm MCQ (SBA): Pneumomediastinum

A 48-year-old woman on ICU develops a pneumomediastinum while on high-PEEP ventilation for ARDS. CXR confirms air in the mediastinum but no pneumothorax. She is haemodynamically stable. What is the most appropriate management?