Your browser doesn't support javascript.
Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review.
Belletti, Alessandro; Todaro, Gabriele; Valsecchi, Gabriele; Losiggio, Rosario; Palumbo, Diego; Landoni, Giovanni; Zangrillo, Alberto.
  • Belletti A; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Todaro G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Valsecchi G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Losiggio R; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Palumbo D; Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Landoni G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Zangrillo A; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Crit Care Med ; 50(3): 491-500, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1462522
ABSTRACT

OBJECTIVE:

There are concerns of a high barotrauma rate in coronavirus disease 2019 patients with acute respiratory distress syndrome receiving invasive mechanical ventilation. However, a few studies were published, and reported rates were highly variable. We performed a systematic literature review to identify rates of barotrauma, pneumothorax, and pneumomediastinum in coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation. DATA SOURCE PubMed and Scopus were searched for studies reporting barotrauma event rate in adult coronavirus disease 2019 patients receiving invasive mechanical ventilation. STUDY SELECTION We included all studies investigating adult patients with coronavirus disease 2019 acute respiratory distress syndrome requiring mechanical ventilation. Case reports, studies performed outside ICU setting, and pediatric studies were excluded. Two investigators independently screened and selected studies for inclusion. DATA EXTRACTION Two investigators abstracted data on study characteristics, rate of pneumothorax, pneumomediastinum and overall barotrauma events, and mortality. When available, data from noncoronavirus disease 2019 acute respiratory distress syndrome patients were also collected. Pooled estimates for barotrauma, pneumothorax, and pneumomediastinum were calculated. DATA

SYNTHESIS:

A total of 13 studies with 1,814 invasively ventilated coronavirus disease 2019 patients and 493 noncoronavirus disease 2019 patients were included. A total of 266/1,814 patients (14.7%) had at least one barotrauma event (pooled estimates, 16.1% [95% CI, 11.8-20.4%]). Pneumothorax occurred in 132/1,435 patients (pooled estimates, 10.7%; 95% CI, 6.7-14.7%), whereas pneumomediastinum occurred in 162/1,432 patients (pooled estimates, 11.2%; 95% CI, 8.0-14.3%). Mortality in coronavirus disease 2019 patients who developed barotrauma was 111/198 patients (pooled estimates, 61.6%; 95% CI, 50.2-73.0%). In noncoronavirus disease 2019 acute respiratory distress syndrome patients, barotrauma occurred in 31/493 patients (6.3%; pooled estimates, 5.7%; 95% CI, -2.1% to 13.5%).

CONCLUSIONS:

Barotrauma occurs in one out of six coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation and is associated with a mortality rate of about 60%. Barotrauma rate may be higher than noncoronavirus disease 2019 controls.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumothorax / Respiration, Artificial / Barotrauma / COVID-19 / Mediastinal Emphysema Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Crit Care Med Year: 2022 Document Type: Article Affiliation country: Ccm.0000000000005283

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumothorax / Respiration, Artificial / Barotrauma / COVID-19 / Mediastinal Emphysema Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Crit Care Med Year: 2022 Document Type: Article Affiliation country: Ccm.0000000000005283