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Case Report: Barotrauma in COVID-19 Case Series
Ramin Sami1, Nafiseh Sereshti2
11Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Summary
Severe acute respiratory syndrome coronavirus 2 (COVID-19) can lead to barotrauma (BT) in intubated patients. High PEEP, bacterial pneumonia, and lung disease history may increase BT risk, with a 12.6% incidence observed.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Severe acute respiratory syndrome coronavirus 2 (COVID-19) is associated with pulmonary complications.
- Barotrauma (BT) is a known risk, but its prevalence and risk factors in COVID-19 patients remain unclear.
Observation:
- A case series analyzed 103 intubated COVID-19 patients over 5 months.
- 13 patients (12.6%) developed barotrauma (BT), with one case preceding intubation.
- All BT patients were male, and 61.53% had Klebsiella pneumoniae coinfection.
Findings:
- Barotrauma (BT) occurred in 12.6% of intubated COVID-19 patients.
- High positive end-expiratory pressure (PEEP), bacterial pneumonia, and prior lung disease may increase BT incidence.
- Mortality was high at 69.9% among patients with BT.
Implications:
- Increased vigilance in ventilator management, particularly during the first week of intubation, is crucial.
- Identifying and mitigating risk factors for barotrauma (BT) in COVID-19 patients is essential for improving outcomes.
- Bacterial coinfections, like Klebsiella pneumoniae, may play a significant role in the development of BT in this population.
