Pressure Injury Induced Pneumothorax in Woman with Schizophrenia

  • Aleksandrs Kagans (Speaker)
  • Rems Zikovs (Co-author)
  • Jānis Zeltiņš (Co-author)
  • Zane Glāzniece-Kagane (Co-author)
  • Afrodīte Jankovska (Co-author)
  • Ozoliņa, A. (Co-author)

Activity: Talk or presentation types › Poster presentation

Description

Pressure injury (PI) is a significant problem worldwide. PI is defined as lesion, that is caused by unrelieved pressure, that results in damage to the underlying tissue. There are four stages of this kind of lesions and may extend from nonblanchable erythema of skin to deep ulcers, reaching bone. The aim is to demonstrate a rare complication of stage IV pressure injury of the chest, that presented as pneumothorax. A case study of 56 year old woman with schizophrenia admitted to the surgery ward, due to altered mental status, hyperpyrexia and hypotension (90/60mm/Hg). At the same day she was transferred to intensive care unit because of progressive hypotension, hypoperfusion, suspected septic shock and respiratory failure (RR 33rpm, SP02 89%). On physical examination we revealed that woman had multiple site PI of varying degree (III-IV). The biggest was on the right side of her chest (28x17cm) with necrosis extending to ribs and intercostal muscles. On the next morning respiratory failure progressed (RR 36rpm, SP02 86%) with absent breathing on the right side of the chest. A CT scan showed a great right-side pneumothorax with communication of pleural spaces to external environment and multiple destructive type rib fractures, bilateral pneumonia and multiple abscess formation. Thoracostomy was performed urgently. Pneumothorax almost resolved on the control X-ray and patient’s condition became more stable (RR 26rpm SP02 95%). She was very cachectic, hypoproteinemic, anemic (Hb 6,9g/l) with signs of shock on admission. There was no possible to repair chest wall in surgical way unless optimizing the patient. Despite adequate antibacterial therapy, fluid and nutritional support, physiotherapy and wound care, patient died on the sixth day of her admission due to progressive vital function exhaustion. Conclusion. PI might be life-threatening conditions and should be evaluated properly especially in patients with complex pathology.. .. .. .
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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