Pneumomediastinum – pro
Per Ebina M. et al. (2017), “Spontaneous pneumomediastinum is a benign condition presenting primarily in young adults, with an uneventful recovery. Therefore, patients may recover from this condition without admission or the need for prophylactic antibiotics.”
Per Heckman AJ1. et al. (2018), “Spontaneous pneumomediastinum, pneumorrhachis, and subcutaneous emphysema are rare clinical entities, but each requires thorough investigation in the ED to rule out any underlying life-threatening cause. A conservative treatment approach is appropriate for most patients without evidence of cardiorespiratory compromise or neurologic deficits accruing due to these problems.”
Per AHRQ (2014), “Recommended Practice: Identification of Patients at Risk• Determine risk for iatrogenic pneumothorax during the history and physical.
• Consider the many factors identified in the literature that are associated with a higher risk of iatrogenic pneumothorax. These can be categorized as either patient related or procedure related.”
Per Potz BA. et al. (2017), “Spontaneous pneumomediastinum is usually associated with a benign clinical course. Risk factors for esophageal perforation in these patients include age, elevated white blood cell count, and a pleural effusion. In the absence of abnormal laboratory values or associated radiologic findings, the majority of patients with SPM may be safely observed without the need for further diagnostic testing.”
PEER REVIEWED PUBLICATION/LITERATURE:
AHRQ Quality Indicators Toolkit. Selected best practices and suggestions for improvement PSI 6: Iatrogenic pneumothorax. Rockville, MD: AHRQ; 2014. http://www.ahrq.gov/professionals/systems/hospital/qitoolkit/d4e-pneumothorax-bestpractices.pdf
Ebina M. et al. (2017). Management of spontaneous pneumomediastinum: Are hospitalization and prophylactic antibiotics needed? Am J Emerg Med. 2017 Aug;35(8):1150-1153. doi: 10.1016/j.ajem.2017.03.017. Epub 2017 Mar 10.
Heckman AJ1. et al. (2018). Concurrent Spontaneous Pneumomediastinum and Pneumorrhachis. J Emerg Med. 2018 Jun;54(6):e117-e120. doi: 10.1016/j.jemermed.2018.02.036. Epub 2018 Apr 21.
Potz BA. et al. (2017). Clinical Significance of Spontaneous Pneumomediastinum. Ann Thorac Surg. 2017 Aug;104(2):431-435. doi: 10.1016/j.athoracsur.2017.02.051. Epub 2017 May 18.