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Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation
Kartikeya Rajdev1, Alan J Spanel2, Sean McMillan2
1Pulmonary, Critical Care & Sleep Medicine, 12284University of Nebraska Medical Center, Omaha, NE, USA.
Journal of Intensive Care Medicine
|May 20, 2021
Summary
Pulmonary barotrauma is common in COVID-19 patients with ARDS, especially those on invasive ventilation. Early recognition and lung-protective strategies are crucial due to high mortality risks.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Infectious Diseases
Background:
- High incidence of pulmonary barotrauma observed in COVID-19 patients with ARDS.
- Need to evaluate barotrauma incidence, outcomes, and characteristics in this population.
Purpose of the Study:
- To assess the incidence and clinical outcomes of barotrauma in COVID-19 patients.
- To compare barotrauma rates between invasive and non-invasive ventilation groups.
Main Methods:
- Retrospective cohort study of 353 adult COVID-19 pneumonia patients with ARDS.
- Patients received either non-invasive (n=232) or invasive (n=121) positive pressure ventilation.
- Data collected on barotrauma development, clinical outcomes, and ventilation strategies.
Main Results:
- Overall barotrauma incidence was 9.07% (32/353 patients).
- Incidence higher in invasive group (17.35%) vs. non-invasive group (4.74%).
- Barotrauma associated with a 62.5% mortality rate and prolonged hospital stay.
Conclusions:
- COVID-19 ARDS patients exhibit a high incidence of pulmonary barotrauma.
- Consider barotrauma in worsening COVID-19 respiratory disease due to high mortality.
- Lung-protective ventilation may mitigate barotrauma risk.
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