Related Experiment Video
Updated: Oct 22, 2025
07:16
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
3.7K
Clinical Course of Mechanically Ventilated COVID-19 Patients With Pneumothoraces
Taha Mallick1, Max Murray Ramcharan2, Anant Dinesh3
1Surgery, Harlem Hospital Center, New York, USA.
Cureus
|September 1, 2021
Summary
Pneumothoraces in mechanically ventilated COVID-19 patients indicate severe lung damage and carry a mortality rate exceeding 90%. Older patients and those with comorbidities face a more severe clinical course.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Infectious Diseases
Background:
- Pneumothoraces in mechanically ventilated COVID-19 patients signify severe lung injury.
- These patients exhibit a high mortality rate, influenced by various clinical factors.
Purpose of the Study:
- To investigate the clinical course and outcomes of COVID-19 patients who develop pneumothoraces during mechanical ventilation.
- To identify factors associated with a worse prognosis in this patient group.
Main Methods:
- Retrospective review of 39 COVID-19 patients with pneumothoraces across 11 New York City hospitals (March-April 2020).
- Statistical analysis using paired t-tests to compare outcomes between demographic and clinical subgroups.
- Data collected on timing of pneumothorax, patient demographics, comorbidities, and mortality.
Main Results:
- 92.3% of patients (36/39) died, with a median of 2 days from pneumothorax to death.
- Pneumothoraces occurred either immediately post-intubation (18 patients) or later during ventilation (21 patients).
- Age > 65 years and presence of comorbidities were significantly associated with a worse clinical course (p < 0.05).
Conclusions:
- COVID-19 patients developing pneumothoraces on mechanical ventilation have an extremely high mortality rate (>90%).
- Advanced age and comorbidities are critical factors predicting a more severe and rapid clinical deterioration.
- Findings underscore the severity of lung damage and the need for vigilant monitoring in this vulnerable population.
Related Concept Videos
01:27Pneumothorax-II
481
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
481
01:26Pneumothorax-I
633
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
633
01:28Pneumonia IV: Management
511
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
511
01:30Pneumonia III: Complications and Assessment
528
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
528
01:26Flail Chest-II
291
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
291
01:29Acute Respiratory Failure-V
239
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
239