{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:46:26Z","timestamp":1780631186258,"version":"3.54.1"},"reference-count":7,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>We describe three patients with chronic obstructive pulmonary disease (COPD) and emphysema who developed a pneumothorax while receiving chronic home non-invasive ventilation (NIV). These cases raise the question whether the high alveolar pressures given by NIV may have contributed to the development of their pneumothorax by barotrauma. Pneumothorax in patients with COPD receiving NIV is uncommon, the pressures in our patients with COPD who developed pneumothorax were not extremely high and time to development of pneumothorax was relatively long after the initiation of NIV. Further, in our patients, the CT scan showed paraseptal emphysema, a known risk factor for pneumothorax. This suggests that COPD\/emphysema phenotype is probably a more important factor for indicating pneumothorax risk than ventilator settings. Better phenotyping of patients with COPD in whom benefits of NIV can be expected at minimal risk of serious side-effects is needed to inform our patients properly and bring the field of chronic NIV in COPD forward.<\/jats:p>","DOI":"10.1136\/bcr-2022-253186","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T10:55:14Z","timestamp":1672656914000},"page":"e253186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Pneumothorax in patients with COPD and emphysema receiving home chronic non-invasive ventilation: is it the emphysema phenotype or ventilator setting?"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0685-320X","authenticated-orcid":false,"given":"Joanne M","family":"Sloots","sequence":"first","affiliation":[{"name":"Department of Pulmonary Diseases\/Home Mechanical Ventilation, University Medical Centre Groningen, Groningen, The Netherlands"},{"name":"Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-9447","authenticated-orcid":false,"given":"Marieke L","family":"Duiverman","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases\/Home Mechanical Ventilation, University Medical Centre Groningen, Groningen, The Netherlands"},{"name":"Groningen Research Institute of Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,2]]},"reference":[{"key":"2025082700180208000_16.1.e253186.1","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-12-112"},{"key":"2025082700180208000_16.1.e253186.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.124263"},{"key":"2025082700180208000_16.1.e253186.3","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S2213-2600(14)70153-5","article-title":"Non-Invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial","volume":"2","author":"K\u00f6hnlein","year":"2014","journal-title":"Lancet Respir Med"},{"key":"2025082700180208000_16.1.e253186.4","first-page":"8","article-title":"Chronic non-invasive ventilation for chronic obstructive pulmonary disease","volume":"9","author":"Raveling","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"2025082700180208000_16.1.e253186.5","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.027318"},{"key":"2025082700180208000_16.1.e253186.6","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.7.620"},{"key":"2025082700180208000_16.1.e253186.7","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.chest.2020.09.086","article-title":"Analysis of pneumothorax in noninvasive ventilator users with Duchenne muscular dystrophy","volume":"159","author":"Cho","year":"2021","journal-title":"Chest"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:18:12Z","timestamp":1756279092000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253186"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,2]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/bcr-2022-253186"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253186","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}