Thoracostomy with placement of the thoracic tube in prone decubit during COVID-19 pandemic

The severe acute respiratory syndrome caused by the SARS-CoV-2 coronavirus, leads to respiratory failure and severe hypoxemia, and requires the implementation of invasive mechanical ventilation in addition to strategies such as prone position to improve arterial oxygenation. Extrapulmonary complications such as spontaneous pneumothorax, pneumomediastinum, pleural effusion complicate its management, especially in the prone position. Chest tube thoracostomy is the first treatment line. This procedure leads to a high risk of contagion by the generation of aerosols, in addition to the risk of lung injury during insertion of the pleural drain due to the prone position. We report a case of SARS-CoV-2 infection with mechanical ventilatory assistance complicated by spontaneous pneumothorax that required placement of pleural drainage when the patient was in the prone position. We describe the technique that is not described in the literature. (C) 2021 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.