Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study - 11/06/21
, Ali Hani Al-Tarbsheh b, 1, Nidhi J. Shah c, 1, Hamid Yaqoob d, 1, Kurt Hu f, 1, Paul J. Feustel g, Ronaldo Ortiz-Pacheco c, e, Kinner M. Patel c, e, Jozef Oweis b, Natalya Kozlova d, Spyridon Zouridis b, Sahar Ahmad c, e, Oleg Epelbaum d, Woon H. Chong a, John T. Huggins h, Biplab K. Saha i, Edward Conuel b, Hau Chieng b, Jeannette Mullins a, Divyansh Bajaj f, Boris Shkolnik a, Rachel Vancavage a , Nagendra Madisi a, Marc A. Judson a
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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 PaO2:FiO2 ratio 105 vs 150, P<0.001 and static respiratory system compliance: 30ml/cmH2O vs 39ml/cmH2O, 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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The incidence of pneumothorax was 10% in critically ill and 13% in mechanically ventilated patients with COVID-19 infection. |
• | Patients who developed a pneumothorax had greater severity of lung disease as compared to those without pneumothorax. |
• | Odds of in-hospital death were increased nearly two-fold in those who had a pneumothorax as compared to those without pneumothorax. |
Keywords : Pneumothorax, Pneumomediastinum, Barotrauma, 2, SARS-CoV-2, Coronavirus disease 2019, COVID-19, Incidence, Mortality
Plan
Vol 184
Article 106464- août 2021 Retour au numéro
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