Citation

Shah SL, Barie PS, Bronstein ME, Chang PH, Gibson CJ, Houng AP, Kelly AE, Lee C, Lodescar RJ, Mahadev S, Shou J, Smith KE, Villegas CV, Winchell RJ, Narayan M. Surg. Infect. (Larchmt) 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/sur.2021.121

PMID

unavailable

Abstract

As the coronavirus disease 2019 (COVID-19) pandemic rages, understanding of disease pathophysiology evolves [1]. Because the primary transmission mode is respiratory droplets, pneumonia is the predominant serious manifestation, requiring oxygen therapy (if not mechanical ventilation) that can be hazardous. We describe a patient with COVID-19 pneumonia who sustained burns and a fatal acute lung injury during oxygen administration by high-flow nasal cannula (HFNC).

A 61-year-old man with diabetes mellitus and hypertension presented elsewhere with a four-day history of worsening dry cough and exertional dyspnea. His room-air oxygen saturation (SaO2) was 80% with a respiratory rate of 30 breaths per minute. Oxygen via HFNC was begun (FIO2 0.7, flow rate 60 L/min). A chest radiograph showed bilateral airspace opacities, and reverse transcriptase-polymerase chain reaction (RT-PCR) testing (nasopharyngeal specimen) detected severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). During oxygen therapy, the patient began charging his smartphone, triggering a spark that ignited the oxygen tubing and the patient's hospital gown, resulting in inhalation injury with full- and partial-thickness torso burns comprising 15% total body surface area. After emergent endotracheal intubation, he was transferred to us for specialty burn care...

Language: en