Mediastinal Emphysema (Pneumomediastinum)

Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma.

Also Known As:

Pneumomediastinum; Emphysema, Interstitial; Emphysema, Pulmonary Interstitial; Emphysemas, Pulmonary Interstitial; Interstitial Emphysema, Pulmonary; Interstitial Emphysemas, Pulmonary; Lung Interstitial Emphysema; Mediastinal Emphysemas; Pneumomediastinums; Pulmonary Interstitial Emphysemas; Emphysema, Mediastinal; Interstitial Emphysema; Interstitial Emphysema of Lung; Pulmonary Interstitial Emphysema

Networked: 1108 relevant articles (39 outcomes, 35 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pneumothorax
2.	COVID-19
3.	Subcutaneous Emphysema
4.	Pneumoperitoneum
5.	Pneumonia (Pneumonitis)

Experts

1.	Soll, R F: 10 articles (10/2007 - 01/2000)
2.	Soll, Roger: 4 articles (12/2014 - 04/2009)
3.	Dimitriou, G: 4 articles (01/2008 - 01/2000)
4.	Greenough, A: 4 articles (01/2008 - 01/2000)
5.	Milner, A D: 4 articles (01/2008 - 01/2000)
6.	da Silva, Orlando: 3 articles (11/2021 - 06/2012)
7.	Ohlsson, Arne: 3 articles (12/2016 - 06/2012)
8.	Blennow, M: 3 articles (10/2007 - 01/2002)
9.	Stevens, T P: 3 articles (10/2007 - 01/2002)
10.	Ohlsson, A: 3 articles (07/2007 - 01/2001)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Mediastinal Emphysema:

1.	Oxygen (Dioxygen)IBA 01/01/1996 - "This was associated with a significant reduction in mean maximum fraction of inspired oxygen (0.57 vs 0.66%; p < 0.01), a decreased incidence of pulmonary interstitial emphysema (7 vs 14%; p < 0.05) and a lowered mortality (21 vs 35%; p < 0.01). " 11/21/2023 - "Atypical features, particularly a persistent oxygen requirement promted further investigation with a subsequent CT Thorax confirming pneumomediastinum. " 05/12/2022 - "Switching patients from continuous positive airways pressure support to oxygen or high flow nasal oxygen after the diagnosis of pneumomediastinum was not associated with difference in mortality. " 01/01/2022 - "Hyperbaric oxygen for the treatment of severe subcutaneous and mediastinal emphysema after Renuvion/J-Plasma therapy®." 03/31/2021 - "We present a case of a civilian diver who developed pneumomediastinum with respiratory symptoms which did not respond to normobaric 100% oxygen. "
2.	Surface-Active Agents (Surfactants)IBA 11/10/2021 - "Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report." 05/01/1992 - "Examination of histological lung sections from non-survivors revealed a higher incidence of severe pulmonary interstitial emphysema in control babies than in those treated with surfactant. " 04/01/1991 - "Surfactant-treated infants had significantly less pulmonary interstitial emphysema than placebo-treated infants (p = 0.02), but there were no other significant differences in mortality rates or morbidity. " 01/01/2021 - "He received one dose of Surfactant and was ventilated using high frequency jet ventilation for development of pulmonary interstitial emphysema. " 05/01/1995 - "In addition, there was a significant reduction in the incidence of overall pulmonary air leak (46% vs 32%; p = 0.009), pneumothorax (27% vs 17%; p = 0.023), and pulmonary interstitial emphysema (40% vs 28%; p = 0.018) in infants treated with synthetic surfactant. "
3.	Anti-Bacterial Agents (Antibiotics)IBA 08/01/2017 - "The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics. " 02/01/2021 - "The pneumomediastinum was treated with prophylactic antibiotics. " 08/01/2017 - "Management of spontaneous pneumomediastinum: Are hospitalization and prophylactic antibiotics needed?" 11/01/2011 - "The patient was diagnosed with cervicofacio mediastinal emphysema and subsequently treated with antibiotics. " 05/01/1991 - "The authors present an illustrative case of spontaneous pneumomediastinum treated with intravenous antibiotics and intensive care unit (ICU) admission despite a normal esophagram. "
4.	Analgesics (Analgesic Drugs)IBA 09/01/2009 - "Spontaneous pneumomediastinum usually resolves spontaneously in several days of treatment, which includes identification of the underlying cause (if possible), rest, analgesics and clinical monitoring. " 09/01/2023 - "Both individuals exhibited signs of pneumomediastinum on imaging studies and were treated with oxygen therapy and analgesics. " 08/01/2020 - "Under the diagnosis of spontaneous pneumomediastinum (SPM) the treatment included conservative therapy with analgesics, rest, and oxygen. " 09/01/2003 - "Conservative treatment consisted of bed rest, oxygen therapy, and analgesics, which led to rapid resolution of the spontaneous pneumomediastinum. " 07/01/2021 - "Our case revealed that oxygen therapy, bed rest, analgesic, and supraclavicular slit-like incision best option for treat subcutaneous emphysema (SE) and spontaneous pneumomediastinum (SPM)."
5.	SteroidsIBA 12/01/2016 - "Steroid-induced resolution of refractory pulmonary interstitial emphysema." 11/01/2022 - "An increasing rate of pneumomediastinum in non-intubated COVID-19 patients: The role of steroids and a possible radiological predictor." 05/01/2014 - "Five of the seven patients with steroid-refractory acute GVHD achieved a complete response, two of two patients with tissue injury (pneumomediastinum/pneumothorax) achieved resolution but there was no response in two subjects with delayed marrow failure. " 02/01/2008 - "On the other hand, pneumomediastinum of the last patient seemed to be associated with interstitial pneumonia and steroid." 06/01/1997 - "During the steroid treatment, bilateral pneumothorax and mediastinal emphysema developed. "
6.	ParaquatIBA 09/07/2023 - "Pneumomediastinum is not an uncommon manifestation of lung toxicity in acute paraquat ingestion. " 12/01/2021 - "Pneumomediastinum and diffuse or symmetrical interstitial or alveolar lung patterns are the most common radiographic features in dogs with paraquat intoxication. " 04/01/2021 - "We recently managed a young patient with paraquat ingestion who developed spontaneous pneumomediastinum. " 11/01/1994 - "In conclusion, mediastinal emphysema observed in paraquat intoxication is not related to the serum level of paraquat. " 11/01/1994 - "Mediastinal emphysema observed in paraquat intoxication always means mortality, however, we experienced a survivor. "
7.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 08/01/2009 - "We report a case presented with the spontaneous pneumomediastinum and subcutaneous emphysema in both ADM and cryptogenic organizing pneumonia during adjuvant chemotherapy based on cyclophosphamide for breast cancer." 01/01/2010 - "[Successful treatment of interstitial pneumonia and pneumomediastinum associated with polymyositis during pregnancy with a combination of cyclophosphamide and tacrolimus: A case report]." 01/01/2018 - "She developed respiratory failure and pneumomediastinum, however her RP-ILD responded favorably to the combined immunosuppressive treatments consisting of steroids, intravenous cyclophosphamide and tacrolimus. " 03/01/2009 - "He was treated with high dose of corticosteroids, cyclophosphamide and cyclosporin A which resulted in the disappearance of the pneumomediastinum and subcutaneous emphysema and the progressive improvement of both parenchymal lung disease and respiratory insufficiency, enabled us to progressively taper the dose of corticosteroids."
8.	Tacrolimus (Prograf)FDA LinkGeneric 02/01/2008 - "Since IP was still active and serum KL-6 remained high, 3 mg/day of tacrolimus was added to control IP further and to reduce the dosage of PSL which was recognized as one of the aggravation factors of pneumomediastinum. " 02/01/2008 - "A case report of rheumatoid arthritis complicated with rapidly progressive interstitial pneumonia, multiple bullae and pneumomediastinum, which was successfully treated with tacrolimus." 01/01/2010 - "[Successful treatment of interstitial pneumonia and pneumomediastinum associated with polymyositis during pregnancy with a combination of cyclophosphamide and tacrolimus: A case report]." 01/01/2018 - "She developed respiratory failure and pneumomediastinum, however her RP-ILD responded favorably to the combined immunosuppressive treatments consisting of steroids, intravenous cyclophosphamide and tacrolimus. "
9.	Antitussive Agents (Antitussives)FDA Link 11/01/2013 - "Chest CT of 18 cases showed pneumomediastinum, 8 cases displayed varied degrees of air in neck, chest; 18 cases of SPM responded well to bed rest, oxygen, antitussive and anti-infection treatment. " 11/01/2008 - "Treatment including bed rest, codeine for its antitussive action, and nitrogen washout resolved the pneumomediastinum within 3 days. " 10/01/2023 - "Pneumomediastinum may need bed rest, oxygen, antitussives, and analgesics, but severe cases may necessitate a chest tube. "
10.	tyloxapol drug combination hexadecanol dipalmitoylphosphatidylcholine (Exosurf Neonatal)FDA Link 12/01/1990 - "Fewer infants in the Exosurf group had pulmonary interstitial emphysema (26 vs 13; p = 0.028). " 12/01/1993 - "Infants given Exosurf had a significant reduction in the incidence of pulmonary interstitial emphysema (PIE), and a marginal decrease in the incidence of pneumothorax. " 08/01/1991 - "Otherwise no significant difference was noted between Exosurf and human surfactant in radiologic severity of respiratory distress syndrome or in the prevalence of pulmonary interstitial emphysema, pneumothorax, and bronchopulmonary dysplasia. "

Therapies and Procedures

1.	Conservative Treatment 10/01/2012 - "We report a rare case of spontaneous IED complicated with pneumomediastinum and successfully improved by conservative management. " 01/01/2012 - "Thoracic CT confirmed suspected pneumomediastinum and the young man has been transferred to specialized DEA, with a good outcome by conservative treatment. " 07/01/2005 - "This procedure was safe, with only 6 cases (6%) of mediastinal emphysema, which improved with conservative treatment. " 10/01/2020 - "Endoscopy excluded oesophageal perforation, a diagnosis of spontaneous pneumomediastinum was made, and her symptoms improved with conservative management. " 01/01/2018 - "Conservative management was initiated and subsequent radiographs and physical examination revealed subsequent improvement in pneumothoraces and pneumomediastinum. "
2.	Therapeutics 11/01/2013 - "Fifteen cases received chest CT or X-ray inspection after therapy, showing that the pneumomediastinum disappeared or significantly absorbed, 3 cases improved in clinical symptom. " 07/01/1991 - "Therapy with HFJV resulted in improved ventilation at lower peak and mean airway pressures, as well as more rapid radiographic improvement of pulmonary interstitial emphysema, in comparison with rapid-rate CV. " 07/01/1948 - "Contribution to the study of the pathogenesis and therapy of subcutaneous and mediastinal emphysema; academic year 1947-1948." 01/01/2023 - "Differentiating spontaneous pneumomediastinum from more severe secondary causes will avoid unnecessary therapy and prolonged hospitalization." 12/01/2022 - "A universal consensus on therapy of spontaneous pneumomediastinum in pregnancy is necessary to reduce the risk of complications."
3.	Catheters 11/22/2023 - "The catheter was connected to a negative-pressure water seal bottle to drain the pneumomediastinum. " 11/01/2016 - "A Case of Pulmonary Interstitial Emphysema Treated by Percutaneous Catheter Insertion in Extremely Low Birth Weight Infant." 11/01/2007 - "Treatment of giant pulmonary interstitial emphysema by ipsilateral bronchial occlusion with a Swan-Ganz catheter." 11/01/1996 - "Resolution of pulmonary interstitial emphysema using a balloon catheter." 06/01/1988 - "The only complication encountered was a case of cervico-mediastinal emphysema caused by displacement of the tracheal catheter."
4.	Bed Rest (Bedrest) 12/01/1992 - "She was treated with bed rest and mediastinal emphysema subsided within 8 days. " 11/01/2000 - "The pneumomediastinum and subcutaneous emphysema gradually subsided after 3 weeks of bed rest. " 01/01/2007 - "His pneumomediastinum disappeared after strict bed rest and he was thereafter successfully treated with oral prednisolone and cyclosporine A. " 11/01/2013 - "Chest CT of 18 cases showed pneumomediastinum, 8 cases displayed varied degrees of air in neck, chest; 18 cases of SPM responded well to bed rest, oxygen, antitussive and anti-infection treatment. " 09/01/2003 - "Conservative treatment consisted of bed rest, oxygen therapy, and analgesics, which led to rapid resolution of the spontaneous pneumomediastinum. "
5.	Esophagectomy 11/01/2020 - "During transcervical minimally invasive esophagectomy on animal model, the mobilization of swine thoracic esophagus with optimal pneumomediastinum pressure 8-12 mmHg is safe and effective based on hemodynamic analysis." 12/01/2022 - "This retrospective study compared the short-term outcomes and surgical invasiveness between thoracoscopic esophagectomy (TE) and mediastinoscopic esophagectomy with pneumomediastinum (pneumatic mediastinoscopic esophagectomy [PME]). " 10/28/2022 - "Hemodynamic derangement associated with tension pneumomediastinum during minimally invasive esophagectomy: A case report." 11/01/2020 - "Meanwhile, the surgical field under different pneumomediastinum pressure was recorded and balanced with animals' hemodynamic changes to determine the optimal pressure for transcervical minimally invasive esophagectomy. " 11/01/2020 - "We conducted transcervical minimally invasive esophagectomy on animal model (swine) under CO2 pneumomediastinum. "