tetano
Editor, Senior Moderator
Respir Med
. 2021 May 13;184:106464.
doi: 10.1016/j.rmed.2021.106464. Online ahead of print.
Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study
Amit Chopra[SUP] 1 [/SUP], Ali Hani Al-Tarbsheh[SUP] 2 [/SUP], Nidhi J Shah[SUP] 3 [/SUP], Hamid Yaqoob[SUP] 4 [/SUP], Kurt Hu[SUP] 5 [/SUP], Paul J Feustel[SUP] 6 [/SUP], Ronaldo Ortiz-Pacheco[SUP] 7 [/SUP], Kinner M Patel[SUP] 7 [/SUP], Jozef Oweis[SUP] 2 [/SUP], Natalya Kozlova[SUP] 4 [/SUP], Spyridon Zouridis[SUP] 2 [/SUP], Sahar Ahmad[SUP] 7 [/SUP], Oleg Epelbaum[SUP] 4 [/SUP], Woon H Chong[SUP] 8 [/SUP], John T Huggins[SUP] 9 [/SUP], Biplab K Saha[SUP] 10 [/SUP], Edward Conuel[SUP] 2 [/SUP], Hau Chieng[SUP] 2 [/SUP], Jeannette Mullins[SUP] 8 [/SUP], Divyansh Bajaj[SUP] 5 [/SUP], Boris Shkolnik[SUP] 8 [/SUP], Rachel Vancavage[SUP] 11 [/SUP], Nagendra Madisi[SUP] 8 [/SUP], Marc A Judson[SUP] 8 [/SUP]
Affiliations
Abstract
Background: The clinical features and outcomes of mechanically ventilated patients with COVID-19 infection who develop a pneumothorax has not been rigorously described or compared to those who do not develop a pneumothorax.
Purpose: To determine the incidence, clinical characteristics, and outcomes of critically ill patients with COVID-19 infection who developed pneumothorax. In addition, we compared the clinical characteristics and outcomes of mechanically ventilated patients who developed a pneumothorax with those who did not develop a pneumothorax.
Methods: This study was a multicenter retrospective analysis of all adult critically ill patients with COVID-19 infection who were admitted to intensive care units in 4 tertiary care centers in the United States.
Results: A total of 842 critically ill patients with COVID-19 infection were analyzed, out of which 594 (71%) were mechanically ventilated. The overall incidence of pneumothorax was 85/842 (10%), and 80/594 (13%) in those who were mechanically ventilated. As compared to mechanically ventilated patients in the non-pneumothorax group, mechanically ventilated patients in the pneumothorax group had worse respiratory parameters at the time of intubation (mean PaO[SUB]2[/SUB]:FiO[SUB]2[/SUB] ratio 105 vs 150, P<0.001 and static respiratory system compliance: 30ml/cmH[SUB]2[/SUB]O vs 39ml/cmH[SUB]2[/SUB]O, P = 0.01) and significantly higher in-hospital mortality (63% vs 49%, P = 0.04).
Conclusion: The overall incidence of pneumothorax in mechanically ventilated patients with COVID-19 infection was 13%. Mechanically ventilated patients with COVID-19 infection who developed pneumothorax had worse gas exchange and respiratory mechanics at the time of intubation and had a higher mortality compared to those who did not develop pneumothorax.
Keywords: 2; Barotrauma; COVID-19; Coronavirus disease 2019; Incidence; Mortality; Pneumomediastinum; Pneumothorax; SARS-CoV-2.
. 2021 May 13;184:106464.
doi: 10.1016/j.rmed.2021.106464. Online ahead of print.
Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study
Amit Chopra[SUP] 1 [/SUP], Ali Hani Al-Tarbsheh[SUP] 2 [/SUP], Nidhi J Shah[SUP] 3 [/SUP], Hamid Yaqoob[SUP] 4 [/SUP], Kurt Hu[SUP] 5 [/SUP], Paul J Feustel[SUP] 6 [/SUP], Ronaldo Ortiz-Pacheco[SUP] 7 [/SUP], Kinner M Patel[SUP] 7 [/SUP], Jozef Oweis[SUP] 2 [/SUP], Natalya Kozlova[SUP] 4 [/SUP], Spyridon Zouridis[SUP] 2 [/SUP], Sahar Ahmad[SUP] 7 [/SUP], Oleg Epelbaum[SUP] 4 [/SUP], Woon H Chong[SUP] 8 [/SUP], John T Huggins[SUP] 9 [/SUP], Biplab K Saha[SUP] 10 [/SUP], Edward Conuel[SUP] 2 [/SUP], Hau Chieng[SUP] 2 [/SUP], Jeannette Mullins[SUP] 8 [/SUP], Divyansh Bajaj[SUP] 5 [/SUP], Boris Shkolnik[SUP] 8 [/SUP], Rachel Vancavage[SUP] 11 [/SUP], Nagendra Madisi[SUP] 8 [/SUP], Marc A Judson[SUP] 8 [/SUP]
Affiliations
- PMID: 34044224
- DOI: 10.1016/j.rmed.2021.106464
Abstract
Background: The clinical features and outcomes of mechanically ventilated patients with COVID-19 infection who develop a pneumothorax has not been rigorously described or compared to those who do not develop a pneumothorax.
Purpose: To determine the incidence, clinical characteristics, and outcomes of critically ill patients with COVID-19 infection who developed pneumothorax. In addition, we compared the clinical characteristics and outcomes of mechanically ventilated patients who developed a pneumothorax with those who did not develop a pneumothorax.
Methods: This study was a multicenter retrospective analysis of all adult critically ill patients with COVID-19 infection who were admitted to intensive care units in 4 tertiary care centers in the United States.
Results: A total of 842 critically ill patients with COVID-19 infection were analyzed, out of which 594 (71%) were mechanically ventilated. The overall incidence of pneumothorax was 85/842 (10%), and 80/594 (13%) in those who were mechanically ventilated. As compared to mechanically ventilated patients in the non-pneumothorax group, mechanically ventilated patients in the pneumothorax group had worse respiratory parameters at the time of intubation (mean PaO[SUB]2[/SUB]:FiO[SUB]2[/SUB] ratio 105 vs 150, P<0.001 and static respiratory system compliance: 30ml/cmH[SUB]2[/SUB]O vs 39ml/cmH[SUB]2[/SUB]O, P = 0.01) and significantly higher in-hospital mortality (63% vs 49%, P = 0.04).
Conclusion: The overall incidence of pneumothorax in mechanically ventilated patients with COVID-19 infection was 13%. Mechanically ventilated patients with COVID-19 infection who developed pneumothorax had worse gas exchange and respiratory mechanics at the time of intubation and had a higher mortality compared to those who did not develop pneumothorax.
Keywords: 2; Barotrauma; COVID-19; Coronavirus disease 2019; Incidence; Mortality; Pneumomediastinum; Pneumothorax; SARS-CoV-2.