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CASE REPORT
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 299-301

Intercostal chest tube drain-related bleeding in a severe COVID-19 pneumonia patient with pneumothorax and its management


1 Department of Anesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
2 Department of Anesthesiology and Critical Care, Military Hospital, Ambala, Haryana, India

Correspondence Address:
Dr. Kaminder Bir Kaur
Department of Anesthesiology and Critical Care, Military Hospital, Ambala - 133 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amhs.amhs_205_21

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Pneumothorax and pneumomediastinum have both been noted to complicate cases of coronavirus disease-19 (COVID-19) requiring hospital admission; however, the incidence is very low with only few cases reported in the literature. Spontaneous pneumothorax was also reported as a complication of the severe acute respiratory syndrome (SARS) with an incidence of 1.7% in hospitalized patients during the SARS pandemic of 2004. COVID-19 is also associated with a hypercoagulable state leading to pulmonary microvasculature thrombosis and systemic thromboembolic manifestations. Therefore, it is standard practice to start low molecular weight heparin (LMWH) for all moderate and severe COVID-19 pneumonia patients. We report a case of spontaneous pneumothorax in a severe COVID-19 pneumonia patient after three weeks of admission, where placing an intercostal drain (ICD) led to persistent bleeding into the ICD. He was managed with an innovative technique of instillation of Adrenaline saline solution three times into the pleural cavity through the ICD tube. Following the instillation of Adrenaline saline solution, the bleeding from the ICD stopped, however, the patient succumbed to his illness.


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