Chest
Volume 93, Issue 4, April 1988, Pages 878-879
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Bilateral Otorrhagia Associated with Continuous Positive Airway Pressure

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A patient had bilateral tympanic membrane rupture and otorrhagia, an unusual complication of continuous positive airway pressure (CPAP). CPAP, applied by a bag/mask system using disposable spring valves, was used to treat acute pulmonary edema during volume resuscitation and vasopressin therapy for bleeding from esophageal varices.

Section snippets

CASE REPORT

A 49-year-old man was admitted with recurrent upper gastrointestinal bleeding. The patient was alert, and his examination was unremarkable. The tympanic membranes and auditory canals were normal. He had adequate arterial oxygenation while breathing supplemental oxygen at 4 L/min by nasal cannula.

Shortly after admission, the patient had profuse hematemesis associated with hypotension which was treated with intravenous (IV) blood and crystalloid administration, as well as intravenous

DISCUSSION

CPAP is an effective and simple method to increase arterial oxygenation in nonintubated patients.2 In this case, intubation was required for hypercapnia, although arterial oxygenation improved with CPAP and increased FIO2.

There are many complications associated with CPAP,3 including subconjunctival emphysema,4 pulmonary venous and systemic gas embolism,5 and corneal abrasions.6 Pneumocephalus has been reported in association with CPAP in a patient with an unrecognized basilar skull fracture.3

ACKNOWLEDGMENTS

We wish to thank Terry P. Clemmer, M.D., for his critical review of this manuscript. A special thanks to Pat Petersen for preparing the manuscript.

REFERENCES (7)

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