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Cardiovascular Images
March 9, 2022

A Man in His 60s With Pneumonia and Multiple Reintubation Attempts

Author Affiliations
  • 1Department of Internal Medicine, Armed Forces Taichung General Hospital, Taichung City, Taiwan
  • 2Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
  • 3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan
  • 4Department of Nutrition, Chung Shan Medical University, Taichung City, Taiwan
JAMA Cardiol. 2022;7(3):e215860. doi:10.1001/jamacardio.2021.5860

A man in his 60s was admitted because of pneumonia with respiratory failure. He was intubated on day 3 and extubated on day 7. On day 9, respiratory acidosis was noted. However, reintubation of the patient was difficult; a total of 3 intubation attempts were made. After successful reintubation, through written communication, the patient reported symptoms of dyspnea, chest pain, and neck pain during periods of daily sedation interruption. Physical examination demonstrated upper trunk tissue distention and crepitus on palpitation. Chest computed tomography revealed pneumopericardium, subcutaneous emphysema, pneumothorax, and pneumoperitoneum (Figure).

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