High Incidence of Barotrauma in Patients With Severe Coronavirus Disease 2019
نویسندگان
چکیده
Objective.: To report the high incidence of barotrauma in critically ill patients admitted to intensive care unit (ICU) with coronavirus disease 2019 (COVID-19) and discuss its implications. Design.: Retrospective cohort study. Setting.: ICU an academic county hospital Los Angeles, CA from March 15-June 20, 2020. Patients.: 77 COVID-19 pneumonia. 75 met inclusion criteria. Results.: 21% severe sustained (33% receiving IMV, 8% (NIV). There were no differences between non-barotrauma groups regarding demographics, illness severity, or medications received, nor tidal volume average/peak airway pressures those IMV. In group there was a greater proportion therapeutic anticoagulation (81% vs. 47%, p = 0.023) ventilated using pressure release ventilation mode (13% 0%, 0.043). Barotrauma associated increased likelihood tracheostomy (OR 2.58 [0.23-4.9], 0.018]), longer median length stay (17 days 7 days, 0.03), hospitalization (26 14 < 0.001). also trend toward prolonged duration IMV (12.5 vs 0.13) higher average mortality (56% 37%, 0.25). Conclusions.: is seen 5-12% ARDS exceedingly rare NIV. We observed requiring either NIV While barotrauma, this did not reach statistical significance. The may be product pathophysiology state heightened inflammatory response causing rampant acute lung injury. Evidence-based medicine lung-protective should remain mainstay treatment.
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ژورنال
عنوان ژورنال: Journal of Intensive Care Medicine
سال: 2021
ISSN: ['0885-0666', '1525-1489']
DOI: https://doi.org/10.1177/0885066621989959