Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Evaluation of Frequency and Risk Factors of Barotrauma among Patients with Severe Covid-19 Pneumonia Underwent Non-Invasive Ventilation in Afzalipour Hospital Kerman

Author(s): Behnam Dalfardi, Seyed Mehdi Hashemi Bajgani, Mohammad Javad Najafzadeh, Mohadeseh Shafiei and Mohsen Shafiepour*

Volume 19, Issue 3, 2023

Published on: 14 June, 2023

Page: [228 - 233] Pages: 6

DOI: 10.2174/1573398X19666230606120912

Price: $65

Open Access Journals Promotions 2
Abstract

Background: Acute respiratory distress syndrome (ARDS) following Covid-19 pneumonia is an important complication; using non-invasive ventilation (NIV) is one of the best supportive options available. In the recent Covid-19 pandemic, we have seen a significant increase in barotrauma incidence following the use of NIV in patients with severe Covid-19 pneumonia. We aimed to identify the risk factors of barotrauma in patients with Covid-19 pneumonia undergoing NIV.

Methods: In this retrospective study, all adult patients with severe Covid-19 pneumonia who undergone NIV and suffered from any form of barotrauma from July to September 2021 in Afzalipour Hospital, Kerman, Iran were evaluated. Laboratory tests and NIV machine settings were collected from patients' files. A chi-square test and an independent t-test were used for analytical statistics.

Results: Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestation of barotrauma was pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and Laboratory tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04).

Conclusion: According to the results of the study, using a low level of IPAP in the ventilator machine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate.

Keywords: Barotrauma, covid-19 pneumonia, acute respiratory distress syndrome, non-invasive ventilation, retrospective study, pneumomediastinum.

Graphical Abstract
[1]
Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci 2020; 57(6): 365-88.
[http://dx.doi.org/10.1080/10408363.2020.1783198] [PMID: 32645276]
[2]
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.
[http://dx.doi.org/10.1016/S2213-2600(20)30079-5] [PMID: 32105632]
[3]
Fan E, Del Sorbo L, Goligher EC, et al. An official American thoracic society/european society of intensive care medicine/society of critical care medicine clinical practice guideline: Mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2017; 195(9): 1253-63.
[http://dx.doi.org/10.1164/rccm.201703-0548ST] [PMID: 28459336]
[4]
Bourke SC, Bullock RE, Williams TL, Shaw PJ, Gibson GJ. Noninvasive ventilation in ALS: Indications and effect on quality of life. Neurology 2003; 61(2): 171-7.
[http://dx.doi.org/10.1212/01.WNL.0000076182.13137.38] [PMID: 12874394]
[5]
Gay PC. Complications of noninvasive ventilation in acute care. Respir Care 2009; 54(2): 246-57.
[PMID: 19173756]
[6]
Carron M, Freo U, BaHammam AS, et al. Complications of non-invasive ventilation techniques: A comprehensive qualitative review of randomized trials. Br J Anaesth 2013; 110(6): 896-914.
[http://dx.doi.org/10.1093/bja/aet070] [PMID: 23562934]
[7]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[8]
Armstrong RA, Kane AD, Cook TM. Outcomes from intensive care in patients with COVID‐19: A systematic review and meta‐analysis of observational studies. Anaesthesia 2020; 75(10): 1340-9.
[http://dx.doi.org/10.1111/anae.15201] [PMID: 32602561]
[9]
Yam LYC, Chen RC, Zhong NS. SARS: Ventilatory and intensive care. Respirology 2003; 8(S1): S31-5.
[http://dx.doi.org/10.1046/j.1440-1843.2003.00521.x] [PMID: 15018131]
[10]
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): E252-62.
[http://dx.doi.org/10.1148/radiol.2020202352] [PMID: 32614258]
[11]
Fowler RA, Lapinsky SE, Hallett D, et al. Critically ill patients with severe acute respiratory syndrome. JAMA 2003; 290(3): 367-73.
[http://dx.doi.org/10.1001/jama.290.3.367] [PMID: 12865378]
[12]
Das KM, Lee EY, Jawder SEA, et al. Acute Middle East respiratory syndrome coronavirus: Temporal lung changes observed on the chest radiographs of 55 patients. AJR Am J Roentgenol 2015; 205(3): W267-S274.
[http://dx.doi.org/10.2214/AJR.15.14445] [PMID: 26102309]
[13]
Stewart TE, Meade MO, Cook DJ, et al. Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. N Engl J Med 1998; 338(6): 355-61.
[http://dx.doi.org/10.1056/NEJM199802053380603] [PMID: 9449728]
[14]
Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342(18): 1301-8.
[http://dx.doi.org/10.1056/NEJM200005043421801] [PMID: 10793162]
[15]
Grasso S, Stripoli T, De Michele M, et al. ARDSnet ventilatory protocol and alveolar hyperinflation: Role of positive end-expiratory pressure. Am J Respir Crit Care Med 2007; 176(8): 761-7.
[http://dx.doi.org/10.1164/rccm.200702-193OC] [PMID: 17656676]
[16]
Boussarsar M, Thierry G, Jaber S, Roudot-Thoraval F, Lemaire F, Brochard L. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intensive Care Med 2002; 28(4): 406-13.
[http://dx.doi.org/10.1007/s00134-001-1178-1] [PMID: 11967593]
[17]
Lemmers DHL, Abu Hilal M, Bnà C, et al. Pneumomediastinum and subcutaneous emphysema in COVID-19: Barotrauma or lung frailty? ERJ Open Res 2020; 6(4): 00385-2020.
[http://dx.doi.org/10.1183/23120541.00385-2020] [PMID: 33257914]
[18]
McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM. High incidence of barotrauma in patients with COVID-19 infection on invasive mechanical ventilation. Radiology 2020; 2: 202352.
[http://dx.doi.org/10.1148/radiol.2020202352]
[19]
Shrestha DB, Sedhai YR, Budhathoki P, et al. Pulmonary barotrauma in COVID-19: A systematic review and meta-analysis. Ann Med Surg 2022; 73103221.
[http://dx.doi.org/10.1016/j.amsu.2021.103221] [PMID: 35003730]
[20]
Rajdev K, Spanel AJ, McMillan S, et al. Pulmonary barotrauma in COVID-19 patients with ARDS on invasive and non-invasive positive pressure ventilation. J Intensive Care Med 2021; 36(9): 1013-7.
[http://dx.doi.org/10.1177/08850666211019719] [PMID: 34013825]
[21]
Kahn MR, Watson RL, Thetford JT, Wong JI, Kamangar N. High incidence of barotrauma in patients with severe coronavirus disease 2019. J Intensive Care Med 2021; 36(6): 646-54.
[http://dx.doi.org/10.1177/0885066621989959] [PMID: 33722090]
[22]
Hamouri S, Samrah SM, Albawaih O, et al. Pulmonary barotrauma in COVID-19 patients: Invasive versus noninvasive positive pressure ventilation. Int J Gen Med 2021; 14: 2017-32.
[http://dx.doi.org/10.2147/IJGM.S314155] [PMID: 34079341]
[23]
Dubey R, Sen KK, Mishra A. Barotrauma and its complications in COVID-19 patients: A retrospective study at tertiary care hospital of Eastern India. Bull Natl Res Cent 2022; 46(1): 212.
[http://dx.doi.org/10.1186/s42269-022-00880-3] [PMID: 35854795]
[24]
Antonio G, Federica S, Brambilla A, Chiara C, Stella I, Francesco B. Occurrence of pneumothorax and pneumomediastinum in Covid-19 patients during non-invasive ventilation with continuous positive airway pressure. medRxiv 2020.
[http://dx.doi.org/10.1101/2020.08.31.20185348]
[25]
Ball L, Serpa Neto A, Trifiletti V, et al. Effects of higher PEEP and recruitment manoeuvres on mortality in patients with ARDS: A systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials. Intensive Care Med Exp 2020; 8(S1): 39.
[http://dx.doi.org/10.1186/s40635-020-00322-2] [PMID: 33336325]
[26]
Santa Cruz R, Villarejo F, Irrazabal C, Ciapponi A. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2021; 3(3): CD009098.
[PMID: 33784416]
[27]
Abdallat M, Khalil M, Al-Awwa G, Kothuru R, La Punzina C. Barotrauma in COVID-19 patients. J Lung Health Dis 2020.
[28]
Belletti A, Todaro G, Valsecchi G, et al. Barotrauma in coronavirus disease 2019 patients undergoing invasive mechanical ventilation: A systematic literature review. Crit Care Med 2022; 50(3): 491-500.
[http://dx.doi.org/10.1097/CCM.0000000000005283] [PMID: 34637421]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy