Clinical characteristics and risk factors of patients with COVID-19 developing barotrauma
Main Article Content
Keywords
COVID-19, Barotrauma, CPAP, BiPAP, NIV, pneumothorax
Abstract
Background: At our hospital, people with COVID-19 (coronavirus disease 2019) had a high rate of pulmonary barotrauma. Therefore, the current study looked at barotrauma in COVID-19 patients getting invasive and non-invasive positive pressure ventilation to assess its prevalence, clinical results, and features.
Methodology: Our retrospective cohort study comprised of adult COVID-19 pneumonia patients who visited our tertiary care hospital between April 2020 and September 2021 and developed barotrauma.
Results: Sixty-eight patients were included in this study. Subcutaneous emphysema was the most frequent type of barotrauma, reported at 67.6%; pneumomediastinum, reported at 61.8%; pneumothorax, reported at 47.1%. The most frequent device associated with barotrauma was CPAP (51.5%). Among the 68 patients, 27.9% were discharged without supplemental oxygen, while 4.4% were discharged on oxygen. 76.5% of the patients expired because of COVID pneumonia and its complications.
In addition, 38.2% of the patients required invasive mechanical breathing, and 77.9% of the patients were admitted to the ICU.
Conclusion: Barotrauma in COVID-19 can pose a serious risk factor leading to mortality. Also, using CPAP was linked to a higher risk of barotrauma.
References
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25. Tacconi F, Rogliani P, Leonardis F, et al. Incidence of pneumomediastinum in COVID-19: a single-center comparison between 1st and 2nd wave. Respiratory Investigation. 2021 Sep 1;59(5):661-5.
26. Edwards JA, Breitman I, Bienstock J, et al. Pulmonary barotrauma in mechanically ventilated coronavirus disease 2019 patients: a case series. Annals of Medicine and Surgery. 2021 Jan 1;61:24-9.
27. Rodriguez-Arciniega TG, Sierra-Diaz E, Flores-Martinez JA, et al. Frequency and risk factors for spontaneous pneumomediastinum in COVID-19 patients. Frontiers in Medicine. 2021 Apr 9;8:405.
28. Jones E, Gould A, Pillay TD, et al. Subcutaneous emphysema, pneumomediastinum, and pneumothorax in critically ill patients with coronavirus disease 2019: a retrospective cohort study. Critical care explorations. 2020 Sep;2(9).
29. Özdemir S, Bilgi DÖ, Köse S, et al. Pneumothorax in patients with coronavirus disease 2019 pneumonia with invasive mechanical ventilation. InteractiveCardioVascular and Thoracic Surgery. 2021 Mar;32(3):351-5.
30. Kahn MR, Watson RL, Thetford JT, et al. High incidence of barotrauma in patients with severe coronavirus disease 2019. Journal of intensive care medicine. 2021 Jun;36(6):646-54.
31. Guven BB, Erturk T, Kompe Ö, et al. Serious complications in COVID-19 ARDS cases: pneumothorax, pneumomediastinum, subcutaneous emphysema and haemothorax. Epidemiology & Infection. 2021;149.
2. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-2.
3. Gomersall CD, Joynt GM, Lam P, et al. Short-term outcome of critically ill patients with severe acute respiratory syndrome. Intensive Care Med. 2004;30(3):381-7.
4. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
5. McGuinness G, Zhan C, Rosenberg N, et al. Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation. Radiology. 2020;297(2):E252-E62.
6. Battisti AS, Haftel A, Murphy-Lavoie HM. Barotrauma. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.; 2022.
7. Hazariwala V, Hadid H, Kirsch D, et al. Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients withCOVID-19 pneumonia, a case report. J Cardiothorac Surg. 2020;15(1):301.
8. Volpi S, Ali JM, Suleman A, et al.. Pneumomediastinum in COVID-19 patients: a case series of a rare complication. Eur J Cardiothorac Surg. 2020;58(3):646-7.
9. Udi J, Lang CN, Zotzmann V, et al. Incidence of Barotrauma in Patients With COVID-19 Pneumonia During Prolonged Invasive Mechanical Ventilation - A Case-Control Study. J Intensive Care Med. 2021;36(4):477-83.
10. Zantah M, Dominguez Castillo E, Townsend R, et al. Pneumothorax in COVID-19 disease- incidence and clinical characteristics. Respir Res. 2020;21(1):236.
11. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23.
12. Bajema KL, Oster AM, McGovern OL, et al. Persons Evaluated for 2019 Novel Coronavirus - United States, January 2020. MMWR Morb Mortal Wkly Rep. 2020;69(6):166-70.
13. Chen N, Zhou M, Dong X, Qu J, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
14. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9.
15. Rajdev K, Spanel AJ, McMillan S, et al. Pulmonary barotrauma in COVID-19 patients with ARDS on invasive and non-invasive positive pressure ventilation. Journal of intensive care medicine. 2021 Sep;36(9):1013-7.
16. Elsaaran H, AlQinai S, AlTarrah D, et al. Prevalence and risk factors of barotrauma in Covid-19 patients admitted to an intensive care unit in Kuwait; a retrospective cohort study. Annals of Medicine and Surgery. 2021 Mar 1;63:102141.
17. Hamouri S, Samrah SM, Albawaih O, et al. Pulmonary barotrauma in COVID-19 patients: invasive versus non-invasive positive pressure ventilation. International journal of general medicine. 2021;14:2017.
18. Chong WH, Saha BK, Hu K, et al. The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: a systematic review. Heart & Lung. 2021 Sep 1;50(5):599-608.
19. Belletti A, Palumbo D, Zangrillo A, et al. Predictors of
pneumothorax/pneumomediastinum in mechanically ventilated COVID-19 patients. Journal of cardiothoracic and vascular anesthesia. 2021 Dec 1;35(12):3642-51.
20. Sethi SM, Ahmed AS, Hanif S, et al. Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan. Epidemiology & Infection. 2021;149.
21. Manna S, Maron SZ, Cedillo MA, et al. Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19. Clinical imaging. 2020 Nov 1;67:207-13.
22. Chopra A, Al-Tarbsheh AH, Shah NJ, et al. Pneumothorax in critically ill patients with COVID-19 infection: incidence, clinical characteristics and outcomes in a case-control multicenter study. Respiratory medicine. 2021 Aug 1;184:106464.
23. Cut TG, Tudoran C, Lazureanu VE, et al. Spontaneous pneumomediastinum, pneumothorax, pneumopericardium and subcutaneous emphysema—Not so uncommon complications in Patients with COVID-19 pulmonary infection—A series of cases. Journal of clinical medicine. 2021 Jan;10(7):1346.
24. Wong K, Kim DH, Iakovou A, et al. Pneumothorax in COVID-19 acute respiratory distress syndrome: Case series. Cureus. 2020 Nov 28;12(11).
25. Tacconi F, Rogliani P, Leonardis F, et al. Incidence of pneumomediastinum in COVID-19: a single-center comparison between 1st and 2nd wave. Respiratory Investigation. 2021 Sep 1;59(5):661-5.
26. Edwards JA, Breitman I, Bienstock J, et al. Pulmonary barotrauma in mechanically ventilated coronavirus disease 2019 patients: a case series. Annals of Medicine and Surgery. 2021 Jan 1;61:24-9.
27. Rodriguez-Arciniega TG, Sierra-Diaz E, Flores-Martinez JA, et al. Frequency and risk factors for spontaneous pneumomediastinum in COVID-19 patients. Frontiers in Medicine. 2021 Apr 9;8:405.
28. Jones E, Gould A, Pillay TD, et al. Subcutaneous emphysema, pneumomediastinum, and pneumothorax in critically ill patients with coronavirus disease 2019: a retrospective cohort study. Critical care explorations. 2020 Sep;2(9).
29. Özdemir S, Bilgi DÖ, Köse S, et al. Pneumothorax in patients with coronavirus disease 2019 pneumonia with invasive mechanical ventilation. InteractiveCardioVascular and Thoracic Surgery. 2021 Mar;32(3):351-5.
30. Kahn MR, Watson RL, Thetford JT, et al. High incidence of barotrauma in patients with severe coronavirus disease 2019. Journal of intensive care medicine. 2021 Jun;36(6):646-54.
31. Guven BB, Erturk T, Kompe Ö, et al. Serious complications in COVID-19 ARDS cases: pneumothorax, pneumomediastinum, subcutaneous emphysema and haemothorax. Epidemiology & Infection. 2021;149.
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Published
May 5, 2023
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How to Cite
Jamil Muqtadir Bhatti, Syed Ali Raza, Irshad Batool Abro, Tooba Khalid Khan, Quratulain Khan, Syed Ali Abbas, Hammad A. Siddique, & FNU Sameeullah. (2023). Clinical characteristics and risk factors of patients with COVID-19 developing barotrauma. Journal of Population Therapeutics and Clinical Pharmacology, 30(9), 178–186. https://doi.org/10.47750/jptcp.2023.30.09.019
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.