Pulmonary Barotrauma

Definition

• Injury to lung tissue from over-expansion and increased pressure.
• Results from too much air reaching the lungs, causing alveolar rupture or injury.

Causes

• Mechanical Ventilation:
  • Too much positive pressure applied can damage alveoli.
  • Peak pressure above 50 cmH2O is concerning for barotrauma.
  • Below this threshold is generally safe, but varies per patient.
• Manual Ventilation with Bag Mask Device:
  • Over-squeezing the bag can force too much air into lungs.
  • Modern devices hold < 2,000 mL of air to reduce risk.

Complications

• Pneumothorax: Air in the pleural space causing lung collapse.
• Pneumomediastinum: Air in the mediastinum (central chest area).
• Pneumoperitoneum: Air in the abdominal cavity.
• Subcutaneous Emphysema: Air under the skin.
• Bronchopleural Fistula: Abnormal connection between bronchial tubes and pleural cavity.

Key Points for Respiratory Therapists

• Monitor peak pressures in mechanical ventilation.
• Ensure proper use of bag mask devices to avoid over-inflation.

Additional Notes

• Each patient may have different tolerance levels.
• For further info, go to respiratorytherapyzone.com.

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• Educational Note: Not a replacement for professional medical advice.
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