If the patient's condition allows, just

Subcutaneous emphysema is relatively common in anesthesia and surgery, and usually self-state. Participation hortanohlotky enough to cause airway obstruction rarely

- but can be rapidly fatal. The sharp increase in intra-alveolar pressure can cause bleeding of air pressure in the perivascular interstitial tissue

, which then analyzes between soft tissue planes, causing swelling and tissue compression. In this patient, air probably also tracked

from the pleural cavity in the subcutaneous tissue through the drain site. The resulting subcutaneous emphysema

can spread extensively to involve the face, arms, chest and abdomen causing disfigurement. Other possible effects depend on the site

participating: >> << hortanohlotky. Compression of the upper respiratory tract may occur, causing an acute obstruction. - Jugular venous compression may occur, leading to cardiac output (reduced venous return) and increased intracranial pressure >>. <<,

Chest wall. Participation leading to airflow limitation,

can happen. Mediastinum. Reduction of cardiac output by compression of the heart and great vessels may occur. ,

- In addition, subcutaneous emphysema may be associated with tension pneumothorax, and

tension pneumopericardium,

causing respiratory failure and decreased cardiac output. It should be noted that this patient developed gross, life-threatening, tension subcutaneous emphysema with positive pressure ventilation

started. Possible reason for such a development could pressure gradient between alveoli and

subcutaneous tissues arising from the alveolar air capture secondary to COPD. The patient had no history of Quincke's edema or recent changes in treatment

suggest an allergic cause for the rapid, generalized swelling of tissues. Dissection of air into the soft tissues of the neck in this condition can lead to sore throat, dysphagia, dysphonia, stridor and dyspnea

, and may resemble symptoms epihlottit. If the patient's condition allows, just chest and lateral soft tissue neck X-rays can help diagnose. Fiber-Optic

nasopharyngeal laryngoscopy may help assessing airway obstruction. However, these studies should not delay definitive management. In most patients, subcutaneous emphysema

passes spontaneously within a few days. High flow oxygen therapy speeds resolution assistance >> << resorption of nitrogen from tissues and stretched pnevmomediastinuma. ,

Limit ventilation with subcutaneous emphysema of the chest wall can be removed from the incision,

, or by incorporating large diameter subcutaneous drains associated with underwater seal and suction. ,,

Symptoms of airway obstruction require immediate intervention. Trachea traheostomycheskoy intubation and emergency (if the former fails

) can be a very difficult and must be made experienced anesthesiologist and surgeon in the operating >> << immediate access to additional personnel and equipment. Anesthesiological assistance depends on the patient's clinical condition

and according to the anesthesiologist, but may include inhalation or me. against induction, awake fiber optic intubation

Tracheostomy or sleep under local anesthesia. Clinically significant pneumothorax requires ICD insertion and pneumopericardium requires decompression using pericardial >> << needles. Release air from subcutaneous emphysema tension can simulate the output voltage pneumothorax, with audible whistling

for inclusion in the IBC, and bubbles underwater seal leakage. Chest X-ray should be performed after insertion to confirm correct placement. ICD, which is still boiling should never be clamped or removed, as it can convert a simple pneumothorax in >> << pneumothorax tension. Some organizations regularly put pressure ISR during transfer from the operating table on the grounds that it would prevent the destruction

or perhaps reflux underwater seal in the pleural cavity if drainage bottle rises during

process. However, if the drainage bottle is kept 1 m below the patient's reflux should not occur

and print should remain intact.

In addition, replacement seals to submarine Heimlich valve can provide secure >> << and effective system for lasix drug heart data transmission. .