When an identifiable causative factor — such as pre-existing asthma or chronic obstructive pulmonary disease (COPD) — is responsible for the development of pneumomediastinum, the condition is classified as secondary pneumomediastinum. The underlying respiratory disease is central to determining the management approach.
Respiratory conditions such as asthma and COPD can lead to pneumomediastinum, particularly during exacerbations characterised by excessive coughing. In these patients, air enters the mediastinum as a consequence of an identifiable cause, and that cause must be addressed as the primary driver of management.
Management is directed at the specific underlying respiratory pathology — asthma or COPD must be adequately treated — alongside a conservative approach to symptom relief and patient monitoring. The structured protocol specifies the full sequence, all components, and the criteria that indicate readiness for discharge.
Complete regimen details are available in the full protocol below.
DOI: 10.3978/j.issn.2072-1439.2015.01.11