From the Research
Chest tube placement is not always necessary for an intubated patient with subcutaneous emphysema, as alternative methods such as percutaneous angiocatheter decompression can be effective in resolving the condition. When a patient is intubated and receiving positive pressure ventilation, any air leak from the lung can worsen rapidly as the pressurized air continues to escape into the pleural space and subsequently into surrounding tissues, causing subcutaneous emphysema. However, a study published in 2018 1 found that percutaneous angiocatheter decompression can be a well-tolerated, readily accessible, low-cost, and simple procedure for the treatment of subcutaneous emphysema.
- The use of percutaneous angiocatheter decompression can help to rapidly stabilize the patient and resolve the subcutaneous emphysema, as seen in a case report of a 75-year-old woman who developed massive subcutaneous emphysema and impending respiratory failure 1.
- The placement of angiocatheter needles for the decompression of subcutaneous air is a technique that can be superior to previously described techniques involving large open 'blow hole' incisions or large bore drains 1.
- While chest tube placement is often considered the standard treatment for subcutaneous emphysema, the use of alternative methods such as percutaneous angiocatheter decompression can be a viable option, especially in cases where chest tube placement is not feasible or is contraindicated.
- It is essential to consider the individual patient's condition and medical history when deciding on the best course of treatment for subcutaneous emphysema, and to consult with a healthcare professional to determine the most appropriate treatment plan.