Pneumothorax in neuromuscular disease associated with lung volume recruitment and mechanical insufflation-exsufflation.

2019-08

McDonald, Luke A

Berlowitz, David J

Howard, Mark E

Rautela, Linda

Chao, Caroline

Sheers, Nicole

Lung volume recruitment

neuromuscular disease

physiotherapy

pneumothorax

respiratory therapy

Journal Article

0000-0001-8364-5995

0000-0003-2543-8722

10.1002/rcr2.447

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.

link

Respirology case reports 2019;7(6):e00447

Respirology case reports

2051-3380