Pneumothorax in neuromuscular disease associated with lung volume recruitment and mechanical insufflation-exsufflation
Luke Andrew McDonald, David John Berlowitz, Mark Erskine Howard, Linda Rautela, Caroline Chao, Nicole Sheers, Luke Andrew McDonald, David John Berlowitz, Mark Erskine Howard, Linda Rautela, Caroline Chao, Nicole Sheers
Abstract
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.
Keywords: Lung volume recruitment; neuromuscular disease; physiotherapy; pneumothorax; respiratory therapy.
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References
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Source: PubMed