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Case report
Successful use of endobronchial valve for persistent air leak in a patient with COVID-19 and bullous emphysema
  1. Biplab K Saha1,
  2. Alyssa Bonnier2,
  3. Woon Hean Chong3 and
  4. Praveen Chenna4
  1. 1Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, Missouri, USA
  2. 2Department of Nursing, Goldfarb School of Nursing at Barnes-Jewish College, St Louis, Missouri, USA
  3. 3Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, New York, USA
  4. 4Pulmonary and Critical Care Medicine, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
  1. Correspondence to Dr Biplab K Saha; spanophiliac{at}yahoo.com

Abstract

Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5–7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.

  • air leaks
  • COVID-19
  • pneumothorax
  • pulmonary emphysema

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-246671

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    Footnotes

    • Contributors BKS, AB and WHC were involved in the planning, data collection and preparation of the initial manuscript. BKS, AB, WHC and PC finalised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.