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Russian Sklifosovsky Journal "Emergency Medical Care"

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A Rare Cause of Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema After Performing Puncture-Dilation Tracheostomy

https://doi.org/10.23934/2223-9022-2025-14-1-224-230

Abstract

Tracheostomy is the most frequently performed operation in the intensive care unit. According to some data, the frequency of performance fluctuates within 0.1–0.5 cases per 1000 patients on artificial ventilation. In recent years, dilation techniques for applying a tracheostomy cannula have been actively developed due to their low trauma , the ability to perform the operation at the patient’s bedside, and rapid healing of the tracheostomy wound. Today, the “gold standard” of tracheostomy is puncture-dilation tracheostomy under fiberoptic bronchoscopic guidance.

This method has its drawbacks, which is confirmed by a large number of complications. Thus, one of the complications of tracheostomy that is difficult to correct is the “gas” syndrome, which includes pneumomediastinum, subcutaneous emphysema and pneumothorax. These complications are considered to be a consequence of damage to the posterior wall of the trachea. Our clinical example demonstrates another mechanism for the development of the above complications.

We present a clinical example of the development of subcutaneous emphysema, pneumomediastinum and pneumothorax without damage to the posterior wall of the trachea.

About the Authors

E. V. Kelekhsaeva
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Elizaveta V. Kelekhsaeva - Anesthesiologist and Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


T. P. Suchilnikova
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Tatyana P. Suchilnikova - Head of the Department of Anesthesiology and Resuscitation No. 3, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


K. A. Popugaev
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Konstantin A. Popugaev - Professor of the RAS, Full Professor, Doctor of Medical Sciences, Deputy Chief Physician for Anesthesiology and Resuscitation, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia; Head of the Department of Anesthesiology-Resuscitation and Intensive Care, Institute of Anesthesiology.

Gamalei Str. 17, Moscow, 123098


A. V. Bondarenko
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Aleksandr V. Bondarenko - Anesthesiologist and Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


Kh. V. Burnatsev
Lomonosov Moscow State University, Medical Research and Educational Center
Russian Federation

Kheta V. Burnatsev - Anesthesiologist and Resuscitator, Department of Anesthesiology and Resuscitation, Medical Scientific and Educational Center, Lomonosov Moscow State University.

Lomonosovsky Prospect, 27, bldg. 10, Moscow, 119991


I. M. Valiev
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Igor M. Valiev - Anesthesiologist-Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


K. V. Vetrova
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Karina V. Vetrova - Anesthesiologist-Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


N. M. Kruglyakov
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Nikolai M. Kruglyakov - Head of the Department of Anesthesiology and Resuscitation No. 2, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


A. K. Semenko
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Anastasia K. Semenko - Anesthesiologist-Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


R. V. Tsakoev
Lomonosov Moscow State University, Medical Research and Educational Center
Russian Federation

Ruslan V. Tsakoev -Anesthesiologist-Resuscitator, Department of Anesthesiology and Resuscitation of the Medical Scientific and Educational Center, Lomonosov Moscow State University.

Lomonosovsky Prospect, 27, bldg. 10, Moscow, 119991


O. O. Tsarakov
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Oleg O. Tsarakov - Anesthesiologist-Resuscitator, Center of Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


F. F. Khamitov
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Firat F. Khamitov - Postgraduate Student, Medical and Biological University of Innovation and Continuous Education, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


O. V. Parinov
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Oleg V. Parinov - Candidate of Medical Sciences, Deputy Director General for Medical Affairs of the Center for Anesthesiology, Resuscitation and Intensive Care, A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


A. S. Samoilov
A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia
Russian Federation

Alexander S. Samoilov - Corresponding Member of the RAS, Full Professor, Doctor of Medical Sciences, Director General of the A.I. Burnazyan Federal Medical Biophysical Center FMBA of Russia.

Gamalei Str. 17, Moscow, 123098


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Review

For citations:

Kelekhsaeva E.V., Suchilnikova T.P., Popugaev K.A., Bondarenko A.V., Burnatsev Kh.V., Valiev I.M., Vetrova K.V., Kruglyakov N.M., Semenko A.K., Tsakoev R.V., Tsarakov O.O., Khamitov F.F., Parinov O.V., Samoilov A.S. A Rare Cause of Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema After Performing Puncture-Dilation Tracheostomy. Russian Sklifosovsky Journal "Emergency Medical Care". 2025;14(1):224-230. (In Russ.) https://doi.org/10.23934/2223-9022-2025-14-1-224-230

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ISSN 2223-9022 (Print)
ISSN 2541-8017 (Online)

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