J Rhinol.  2023 Mar;30(1):41-44. 10.18787/jr.2023.00004.

Pneumothorax Induced by Automatic Positive Airway Pressure Therapy for Obstructive Sleep Apnea: A Rare Case Report and Review of the Literature

• Kang MJ
• Kang YJ
• Park CS

• KMID: 2540857
• DOI: http://doi.org/10.18787/jr.2023.00004

Abstract

Positive airway pressure (PAP) therapy is known to be an effective treatment for obstructive sleep apnea (OSA) that does not generally have serious complications. However, pneumothorax following lung barotrauma with the use of PAP has rarely been reported. We recently experienced the case of a 72-year old male patient with chronic obstructive pulmonary disease who developed pneumothorax after the use of automatic PAP (APAP). After 4 months of APAP use with a pressure of 4–8 cm H₂O, he complained of sudden severe dyspnea at midnight. He eventually underwent surgical repair for pneumothorax. After 4 months, continuous PAP with low pressure of 5 cm H₂O was applied without any complications. In summary, we emphasize the risk of barotrauma when PAP is used by OSA patients with lung disease.

Keyword

Continuous positive airway pressure; Pneumothorax; Barotrauma; Sleep apnea, Obstructive

Figure

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  Fig. 1. Chest X-ray imaging at the first visit. Only fibrocalcific scars in both lung fields, small calcified granulomas in the right lower lung field, and mild emphysematous changes in both lungs were observed.

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  Fig. 2. Chest X-ray imaging before and after the operation. A: Chest X-ray before the chest tube change. Right pneumothorax and the inserted chest tube were observed. B: Chest X-ray 2 days after the operation. Pleural effusion and a reduced amount of pneumothorax were observed. C: Chest X-ray 4 months after the surgery. The pneumothorax had improved.

Reference

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