Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study
Objective. Pulmonary barotrauma has been frequently observed in patients with COVID-19 who present with acute hypoxemic respiratory failure. This study evaluated the prevalence, risk factors, and outcomes of barotrauma in patients with COVID-19 requiring ICU admission. Methods. This retrospective co...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/4675910 |
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| author | Hasan M. Al-Dorzi Haifa Almujaydia Reema Nazer Yara Alhusaini Aminah Alhamdan Ajyad Al Jawad |
| author_facet | Hasan M. Al-Dorzi Haifa Almujaydia Reema Nazer Yara Alhusaini Aminah Alhamdan Ajyad Al Jawad |
| author_sort | Hasan M. Al-Dorzi |
| collection | DOAJ |
| description | Objective. Pulmonary barotrauma has been frequently observed in patients with COVID-19 who present with acute hypoxemic respiratory failure. This study evaluated the prevalence, risk factors, and outcomes of barotrauma in patients with COVID-19 requiring ICU admission. Methods. This retrospective cohort study included patients with confirmed COVID-19 who were admitted to an adult ICU between March and December 2020. We compared patients who had barotrauma with those who did not. A multivariable logistic regression analysis was performed to determine the predictors of barotrauma and hospital mortality. Results. Of 481 patients in the study cohort, 49 (10.2%, 95% confidence interval: 7.6–13.2%) developed barotrauma on a median of 4 days after ICU admission. Barotrauma manifested as pneumothorax (N = 21), pneumomediastinum (N = 25), and subcutaneous emphysema (N = 25) with frequent overlap. Chronic comorbidities and inflammatory markers were similar in both patient groups. Barotrauma occurred in 4/132 patients (3.0%) who received noninvasive ventilation without intubation, and in 43/280 patients (15.4%) who received invasive mechanical ventilation. Invasive mechanical ventilation was the only risk factor for barotrauma (odds ratio: 14.558, 95% confidence interval: 1.833–115.601). Patients with barotrauma had higher hospital mortality (69.4% versus 37.0%; p<0.0001) and longer duration of mechanical ventilation and ICU stay. Barotrauma was an independent predictor of hospital mortality (odds ratio: 2.784, 95% confidence interval: 1.310–5.918). Conclusions. Barotrauma was common in critical COVID-19, with invasive mechanical ventilation being the most prominent risk factor. Barotrauma was associated with poorer clinical outcomes and was an independent predictor of hospital mortality. |
| format | Article |
| id | doaj-art-e05015dcde43471fbd17feb0b6c836fc |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-e05015dcde43471fbd17feb0b6c836fc2025-02-06T00:00:01ZengWileyCritical Care Research and Practice2090-13132023-01-01202310.1155/2023/4675910Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort StudyHasan M. Al-Dorzi0Haifa Almujaydia1Reema Nazer2Yara Alhusaini3Aminah Alhamdan4Ajyad Al Jawad5College of MedicineCollege of MedicineCollege of MedicineCollege of MedicineCollege of MedicineCollege of MedicineObjective. Pulmonary barotrauma has been frequently observed in patients with COVID-19 who present with acute hypoxemic respiratory failure. This study evaluated the prevalence, risk factors, and outcomes of barotrauma in patients with COVID-19 requiring ICU admission. Methods. This retrospective cohort study included patients with confirmed COVID-19 who were admitted to an adult ICU between March and December 2020. We compared patients who had barotrauma with those who did not. A multivariable logistic regression analysis was performed to determine the predictors of barotrauma and hospital mortality. Results. Of 481 patients in the study cohort, 49 (10.2%, 95% confidence interval: 7.6–13.2%) developed barotrauma on a median of 4 days after ICU admission. Barotrauma manifested as pneumothorax (N = 21), pneumomediastinum (N = 25), and subcutaneous emphysema (N = 25) with frequent overlap. Chronic comorbidities and inflammatory markers were similar in both patient groups. Barotrauma occurred in 4/132 patients (3.0%) who received noninvasive ventilation without intubation, and in 43/280 patients (15.4%) who received invasive mechanical ventilation. Invasive mechanical ventilation was the only risk factor for barotrauma (odds ratio: 14.558, 95% confidence interval: 1.833–115.601). Patients with barotrauma had higher hospital mortality (69.4% versus 37.0%; p<0.0001) and longer duration of mechanical ventilation and ICU stay. Barotrauma was an independent predictor of hospital mortality (odds ratio: 2.784, 95% confidence interval: 1.310–5.918). Conclusions. Barotrauma was common in critical COVID-19, with invasive mechanical ventilation being the most prominent risk factor. Barotrauma was associated with poorer clinical outcomes and was an independent predictor of hospital mortality.http://dx.doi.org/10.1155/2023/4675910 |
| spellingShingle | Hasan M. Al-Dorzi Haifa Almujaydia Reema Nazer Yara Alhusaini Aminah Alhamdan Ajyad Al Jawad Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study Critical Care Research and Practice |
| title | Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study |
| title_full | Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study |
| title_fullStr | Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study |
| title_full_unstemmed | Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study |
| title_short | Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study |
| title_sort | occurrence risk factors and outcomes of pulmonary barotrauma in critically ill covid 19 patients a retrospective cohort study |
| url | http://dx.doi.org/10.1155/2023/4675910 |
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