<div>Hyperbaric oxygen therapy for carbon monoxide poisoning in an adolescent
with Pneumomediastinum after COVID-19 pneumonia : a case report</div><div>ABSTRACT</div><div>Little is known about the complications of COVID-19. What happens when a
patient with carbon monoxide poisoning has complications from COVID-19
pneumonia (a disease that has emerged since 2019 and quickly caused a
pandemic around the world)? We report a case of carbon monoxide
poisoning with COVID-19 pneumonia resulting in secondary
pneumomediastinum. The patient underwent systemic hyperbaric oxygen
therapy for two weeks and most of his symptoms improved. This case
illustrates the success of hyperbaric oxygen in the simultaneous
treatment of COVID-19 pneumonia, pneumomediastinum, and carbon monoxide
poisoning.</div><div>KEYWORDS</div><div>pneumomediastinum；hyperbaric oxygen；carbon monoxide poisoning；
complication；COVID-19</div><div>BACKGROUND</div><div>The patient was admitted with coma due to carbon monoxide poisoning.
However, we unexpectedly found that he also had symptoms of COVID-19
pneumonia and pneumomediastinum during our routine examination. The
reason for his pneumomediastinum is probably related to COVID-19
pneumonia. Pneumomediastinum has been reported among COVID-19
complications in most countries,[1, 2] but its pathogenesis remains
unclear. It has been suggested that the destruction of alveoli from
cytokine storm or mechanical ventilation in prone position may be the
cause of pneumomediastinum[3]. We conducted a relevant search in the
database and developed the hyperbaric oxygen treatment plan. During the
treatment, we found that the patient’s pneumomediastinum and pneumonia
were cured with the improvement of the patient’s poisoning symptoms.</div><div>CASE PRESENTATION</div><div>A 15-year-old adolescent with COVID-19 pneumonia was previously in good
health with no history of chronic disease or family genetic history. His
parents and brothers were in good health. On arrival at the hospital, he
had been poisoned for 11 hours. At this time, the patient was
unconscious. After an emergency CT examination, we found that he had
pneumomediastinum and bilateral pneumonia. No obvious abnormalities in
the brain.There was no obvious abnormality in the brain. His vital signs
are lethargy, normal blood pressure, temperature 37℃, heart rate 86/min,
respiration rate 19/min. Physical examination Both lungs breathing
sounds rough, full of wet rales. Computed tomography (CT) showed patchy
and clouded high-density shadows with blurred boundaries in both lungs.
Gas shadows can be seen in bilateral chest wall, subcutaneous soft
tissue in axilla and mediastinum. Laboratory test: FCOHb7.4%, lactate
1.7mmol/L, WBC18.89×10 ^9/L,CRP121.56mg/L, aspartate aminotransferase
114U/L, aspartate aminotransferase isoenzyme 30U/L, creatine kinase
4522U/L, lactate dehydrogenase 389U/L.</div>