Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.039
Brazilian Journal of Anesthesiology
Case Report

A rare complication of continuous positive airway pressure treatment–rectus sheath hematoma: a case report

Adnan Yamanoğlu, Serkan Bilgin, Nalan Gokce Celebi Yamanoglu, Fatih Esad Topal

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Abstract

Noninvasive mechanical ventilation (NIMV) has a relevant role in the treatment of critically ill patients displaying severe dyspnea. Continuous positive airway pressure (CPAP), a method of NIMV, is also widely used in the management of acute heart failure, chronic obstructive pulmonary disease (COPD) exacerbation, and symptomatic sleep apnea. However, numerous traumatic complications of CPAP treatment in the face region, head, and thorax have been reported and may be related to the application of a continuous positive high pressure to the airway. Conversely, we have observed no complications due to CPAP-related increased intra-abdominal pressure.

In this article, we describe a clinical case of a patient with an acute rectus sheath hematoma during CPAP treatment. This previously unreported complication demonstrates that CPAP should be carefully used in patients with exacerbated COPD with difficulty in expiration

Keywords

Bedside ultrasound;  Chronic obstructive pulmonary disease;  Dyspnea;  Emergency medicine;  Noninvasive mechanical ventilation

References

[1] C. Sullivan, F. Issa, M. Berthon-Jones, et al. Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares Lancet., 1 (1981), pp. 862-865

[2] Parsons PE, Finlay G, Hyzy RC, et al. Noninvasive ventilation in adults with acute respiratory failure: Benefits and contraindications. Retrieved at 10 July at: https://www.uptodate.com/contents/noninvasive-ventilation-in-adults-with-acute-respiratory-failure-benefits-and-contraindications.

[3] L.K. Weaver, W.R. Fairfax, L. Greenway Bilateral otorrhagia associated with continuous positive airway pressure Chest., 93 (1988), pp. 878-879

[4] C.J. Lehmann, A.S. Daftary, E.M. Machogu Apical Lung Herniation Associated with Continuous Positive Airway Pressure in a 4-Year-Old Girl J Clin Sleep Med., 12 (2016), pp. 1565-1566

[5] A. Hatjipetrou, D. Anyfantakis, M. Kastanakis Rectus sheath hematoma: a review of the literature Int J Surg., 13 (2015), pp. 267-271
 

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