Article: High Incidence of Barotrauma in Patients with COVID-19 Infection on Invasive Mechanical Ventilation
Radiology
Abstract: ... mechanical ventilation had a higher rate of barotrauma than patients with ARDS and patients without COVID-19 infection ... without COVID-19 infection (64 ± 19 years, 52% male) with invasive mechanical ventilation had 1 barotrauma event ... in patients with COVID-19 infection was greater than other patients requiring invasive mechanical ventilation ...
| Abstract | Background We observed a high number of patients with COVID-19 pneumonia who had barotrauma related to invasive mechanical ventilation at our institution Purpose To determine if the rate of barotrauma in patients with COVID-19 infection was greater than other patients requiring invasive mechanical ventilation at our institution Methods In this retrospective study, clinical and imaging data of patients seen between 03/01/2020 and 04/06/2020 who tested positive for COVID-19 and experienced barotrauma associated with invasive mechanical ventilation were compared to patients without COVID-19 infection during the same period Historical comparison was made to barotrauma rates of patients with acute respiratory distress syndrome (ARDS) from 02/01/2016 to 02/01/2020 at our institution Comparison of patient groups was performed using categorical or continuous statistical testing as appropriate with multivariable regression analysis Patient survival was assessed using Kaplan-Meier curves analysis Results 601 patients with COVID-19 infection underwent invasive mechanical ventilation (63 ± 15 years, 71% men) There were 89/601 (15%) patients with one or more barotrauma events, for a total of 145 barotrauma events (24% overall events) (95% CI 21-28%) During the same period, 196 patients without COVID-19 infection (64 ± 19 years, 52% male) with invasive mechanical ventilation had 1 barotrauma event ( 5% 95% CI, 0-3%, p< 001 vs the group with COVID-19 infection) Of 285 patients with ARDS over the prior 4 years on invasive mechanical ventilation (68 ± 17 years, 60% men), 28 patients (10%) had 31 barotrauma events, with overall barotrauma rate of 11% (95% CI 8-15%, p< 001 vs the group with COVID-19 infection) Barotrauma is an independent risk factor for death in COVID-19 (OR=2 2, p= 03), and is associated with longer hospital length of stay (OR= 92, p< 001) Conclusion Patients with COVID-19 infection and invasive mechanical ventilation had a higher rate of barotrauma than patients with ARDS and patients without COVID-19 infection |
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| Keywords | covid19 |
| Publisher | WHO |
| Document type | Article |
| Note | WHO #Covidence: #624965 |
| Database | COVID19 |
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