ArticleThe American journal of case reports2026
Secondary Pneumomediastinum Following Bronchoscopic Interventions in Patients With Prolonged Tracheostomy Intubation: A Case Series.
Article in The American journal of case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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 REPORT 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 tracheal polypectomy. Computed tomography (CT) ruled out tension pneumothorax, and stable hemodynamics justified successful conservative management. A 69-year-old patient experienced sudden dyspnea and SE during bedside bronchoscopy. CT revealed extensive soft-tissue gas and left-sided pneumothorax, requiring an emergency bedside subcutaneous incision and closed chest drainage due to rapid respiratory deterioration. A 19-year-old patient developed rapidly spreading SE and progressed to cardiac arrest during a bronchoscopic polypectomy. Malignant tension pneumomediastinum ensued following massive gas entry, severely obstructing venous return, which proved fatal despite advanced life support. CONCLUSIONS Secondary pneumomediastinum during airway manipulation demands a high index of clinical suspicion. While stable cases resolve conservatively, rapid gas accumulation causes obstructive shock requiring immediate thoracic decompression. Strict preoperative cough suppression and continuous cuff pressure monitoring are critical preventative strategies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.