Pneumothorax in neuromuscular disease associated with lung volume recruitment and mechanical insufflation-exsufflation.
Luke Andrew McDonaldDavid John BerlowitzMark Erskine HowardLinda RautelaCaroline ChaoNicole SheersPublished in: Respirology case reports (2019)
A 25-year-old male with Duchenne muscular dystrophy and a 73-year-old male with motor neurone disease both presented with chest pain and increasing dyspnoea following routine mechanical insufflation-exsufflation or lung volume recruitment, on a background of long-term non-invasive ventilation. In each case, chest radiograph revealed a pneumothorax. In both cases the pneumothorax fully resolved following insertion of an intercostal catheter. There was no immediate recurrence and the patients were discharged home and ceased ongoing prophylactic respiratory therapy, although one person had recurrent pneumothoraces subsequently. This rare but serious complication highlights the need for careful risk/benefit analysis by clinicians prescribing these therapies.
Keyphrases
- duchenne muscular dystrophy
- end stage renal disease
- newly diagnosed
- ejection fraction
- primary care
- healthcare
- chronic kidney disease
- peritoneal dialysis
- ultrasound guided
- emergency department
- patient reported outcomes
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- cell therapy
- electronic health record
- smoking cessation
- drug induced