Barotrauma — Lung Damage Secondary to Pressure

Abstract

Barotrauma infers lung damage secondary to intra-thoracic pressure. This most commonly occurs in intensive care during positive pressure ventilation. Contrary to commonly held opinion, pneumothoraces do not usually occur as a result of the repture of a bleb or vesicle on the surface of the lung. The increased pressure causes many small alveoli to rupture simultaneously. The gas moves into the peri-vascular space and accompanies the pulmonary vessels through the lung hila into the mediastinum [1]. The gas either accumulates there, or if the pressure continues, moves up into the neck and over the body to form subcutaneous emphysema (SE), ruptures the mediastinal pleura to cause a pneumothorax (PT) or moves adjacent to the aorta and oesophagus to form pneumoretroperitoneum (PRP) and with even higher pressure, bursts through the peritoneum, to form pneumoperitoneum (PP).