Related Experiment Videos
Clinical risk factors for pulmonary barotrauma: a multivariate analysis
R B Gammon1, M S Shin, R H Groves
1Department of Medicine, Birmingham Veterans Administration Medical Center, Alabama, USA.
American Journal of Respiratory and Critical Care Medicine
|October 1, 1995
Summary
Elevated airway pressures do not independently cause ventilator-induced pneumothorax. Acute Respiratory Distress Syndrome (ARDS) is the primary risk factor, with male sex also a factor in ARDS patients.
Area of Science:
- Critical Care Medicine
- Pulmonary Medicine
- Mechanical Ventilation
Background:
- Previous studies suggested a link between high airway pressures and ventilator-induced pneumothorax.
- Multivariate risk factor analysis for pneumothorax has been limited.
Purpose of the Study:
- To investigate if airway pressures independently correlate with pneumothorax, considering underlying disease.
- To identify independent risk factors for pneumothorax in ventilated patients.
Main Methods:
- Prospective study of 168 ventilated patients over one year.
- Daily collection of ventilator data and review of chest radiographs for pneumothorax.
- Logistic regression analysis including airway pressures, ventilation parameters, age, sex, and underlying disease.
Main Results:
- Pneumothorax occurred in 20 of 168 patients.
- Multivariate analysis identified Acute Respiratory Distress Syndrome (ARDS) as the sole independent predictor of pneumothorax in the overall population.
- In ARDS patients, male sex was the only independent predictor; elevated airway pressures showed a non-significant trend.
Conclusions:
- Underlying disease, specifically ARDS, is the primary risk factor for pneumothorax.
- The association between high airway pressures and barotrauma is largely explained by the higher prevalence of elevated pressures in ARDS patients.