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.
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