Congestion in the tube: air trapping in a ventilated patient with COVID-19 secondary to mucinous valves.

Mina Nasr Arsanious, Eduardas Ambrasas, Mandeep Phull, Thusith Wickrama

Open access · bronzeAbstract readCase Reports

In one paragraph

Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact, top 95% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Mina Nasr ArsaniousAnaesthetics and Critical Care, The Royal London Hospital, London, UK mina.arsanious@nhs.net.ORCID http://orcid.org/0000-0001-8980-7422

Eduardas AmbrasasIntensive Care, Barking Havering and Redbridge Hospitals NHS Trust, Romford, UK.

Mandeep PhullIntensive Care, Barking Havering and Redbridge Hospitals NHS Trust, Romford, UK.

Thusith WickramaIntensive Care, Barking Havering and Redbridge Hospitals NHS Trust, Romford, UK.

Barking, Havering And Redbridge University Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A woman in her 50s was admitted to the intensive therapy unit with acute hypoxaemic respiratory failure secondary to COVID-19 pneumonitis. The patient was intubated on admission and worsening gas exchange necessitated multiple rounds of proning . She later improved, and her ventilation was switched to spontaneous mode. However, the patient started to develop air trapping with subsequent respiratory and cardiovascular compromise. Routine investigations showed no clear cause for her sudden deterioration and a suction catheter passed easily through the endotracheal tube. Bronchoscopy revealed mucinous/phlegmatic membranes had developed across the inner diameter of the endotracheal tube. This had created a one-way valve that allowed positive pressure ventilation through the tube into her lungs but only allowed a fraction of air to passively escape in expiration. This case report highlights a less commonly regarded complication associated with long-term intubation and lack of circuit humidification in the context of productive lung pathology.

Indexed as

COVID-19Respiratory InsufficiencyFemaleHumansIntubation, IntratrachealRespiration, ArtificialSuctionAdult intensive careCOVID-19Healthcare improvement and patient safetyMechanical ventilationRespiratory system

Identifiers

PMID35418374

DOI10.1136/bcr-2021-245625

PMCPMC9013956

OpenAlexW4223889229

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.