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ENDOBRONCHIAL VALVE POSITIONING FOR ALVEOLAR-PLEURAL FISTULA COMPLICATING SEVERE COVID-19 PNEUMONIA

Filippo Gozzi, Roberto Tonelli, Dario Andrisani, Ivana Castaniere, Pierluigi Donatelli, Fabiana Trentacosti, Mariarosaria Pellegrino, Giulia Bruzzi, Linda Manicardi, Antonio Moretti, Chiara Nani, Caterina Cerbone, Morgana Vermi, Alessandro Andreani, Gaia Cappiello, Enrico Clini, Alessandro Marchioni
European Respiratory Journal 2021 58: PA842; DOI: 10.1183/13993003.congress-2021.PA842
Filippo Gozzi
1Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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  • For correspondence: fillo.gzz@gmail.com
Roberto Tonelli
1Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Dario Andrisani
1Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Ivana Castaniere
1Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Pierluigi Donatelli
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Fabiana Trentacosti
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Mariarosaria Pellegrino
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Giulia Bruzzi
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Linda Manicardi
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Antonio Moretti
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Chiara Nani
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Caterina Cerbone
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Morgana Vermi
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Alessandro Andreani
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Gaia Cappiello
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Enrico Clini
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Alessandro Marchioni
2University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy, Modena, Italy
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Abstract

Background: Since December 2019, the world has experienced a pandemic of novel Coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). The main clinical consequences are pneumonia and respiratory failure even requiring mechanical ventilation, frequently sharing clinical and radiologic similarities to acute respiratory distress syndrome (ARDS). In this context, the lung parenchyma is highly prone to ventilator-related injury, with pneumothorax and persistent air leak as the most serious adverse events. So far, endobronchial valve (EBV) positioning has proved efficacious in treating air leaks with a high success rate.

Case presentation: We report, for the first time, two cases of patients affected by SARS-CoV-2-related pneumonia experiencing pneumothorax and persistent air leaks after invasive mechanical ventilation, and successfully treated through EBV positioning.

Conclusions: Persistent air leaks may result from lung tissue damage due to a complex interaction between inflammation and ventilator-related injury (VILI), especially in the advanced stages of ARDS. EBV positioning seems to be a feasible and effective minimally invasive therapeutic option for treating this subset of patients.

  • Airway management
  • Bronchoscopy

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA842.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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ENDOBRONCHIAL VALVE POSITIONING FOR ALVEOLAR-PLEURAL FISTULA COMPLICATING SEVERE COVID-19 PNEUMONIA
Filippo Gozzi, Roberto Tonelli, Dario Andrisani, Ivana Castaniere, Pierluigi Donatelli, Fabiana Trentacosti, Mariarosaria Pellegrino, Giulia Bruzzi, Linda Manicardi, Antonio Moretti, Chiara Nani, Caterina Cerbone, Morgana Vermi, Alessandro Andreani, Gaia Cappiello, Enrico Clini, Alessandro Marchioni
European Respiratory Journal Sep 2021, 58 (suppl 65) PA842; DOI: 10.1183/13993003.congress-2021.PA842

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ENDOBRONCHIAL VALVE POSITIONING FOR ALVEOLAR-PLEURAL FISTULA COMPLICATING SEVERE COVID-19 PNEUMONIA
Filippo Gozzi, Roberto Tonelli, Dario Andrisani, Ivana Castaniere, Pierluigi Donatelli, Fabiana Trentacosti, Mariarosaria Pellegrino, Giulia Bruzzi, Linda Manicardi, Antonio Moretti, Chiara Nani, Caterina Cerbone, Morgana Vermi, Alessandro Andreani, Gaia Cappiello, Enrico Clini, Alessandro Marchioni
European Respiratory Journal Sep 2021, 58 (suppl 65) PA842; DOI: 10.1183/13993003.congress-2021.PA842
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