Barotrauma in COVID-19 Patients
Abstract
Clinical manifestations of COVID 19 is still unknown. We performed this study to determine the occurrence of pulmonary barotrauma as a complication of this disease.
In this retrospective study, a total of 955 COVID 19 patients with respiratory insufficiency requiring oxygen support or invasive ventilation admitted to ICU of Sina Hospital from 20 March 2020 to 9 June 2021, were included and their chest imaging reviewed. Here, we report results of chest imaging of first 92 patients of this group.
Barotrauma (pneumothorax, pneumomediastinum, pneumopericardium) occurred in 11 (11.9%) of 92 patients with coronavirus disease 2019 (COVID-19) infection requiring ICU admission for respiratory support and monitoring.
It seems barotrauma is a common complication of COVID 19 disease. The role of increased respiratory efforts, patient or ventilation induced lung injury, viral and host response should be assessed. It needs to consider the occurrence of barotrauma in Patients with COVID-19, before expansion of dead space treatment and limiting the ventilation effects.
[2] McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM, et al. Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation. Radiology. 2020; 297(2):E252-E262.
[3] Gattinoni L, Marini JJ, Camporota L. The Respiratory Drive: An Overlooked Tile of COVID-19 Pathophysiology. Am J Respir Crit Care Med. 2020; 202(8):1079-1080.
[4] Koyner JL, Murray PT. Mechanical ventilation and the kidney. Blood Purif. 2010;29(1):52-68.
[5] Doty JM, Saggi BH, Blocher CR, Fakhry I, Gehr T, Sica D, et al. Effects of increased renal parenchymal pressure on renal function. J Trauma. 2000; 48(5): 874-877.
[6] Sugerman HJ. Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am. 2001; 81: 1063-75.
[7] Shear W, Rosner MH. Acute kidney dysfunction secondary to the abdominal compartment syndrome. J Nephrol. 2006; 19(5):556-65.
[8] Dupont V, Gamblin C, Bard M, Julien G, Bonnivard M, Champenois V, et al. Severe Intraabdominal Hypertension in Critically Ill COVID-19 Patients With Acute Kidney Injury. Chest. 2021; 160(2):558-561.
[9] Dupont V, Debrumetz A, Leguillou A, Morland D, Wynckel A, Colosio C, et al. Intra-abdominal hypertension in early post-kidney transplantation period is associated with impaired graft function. Nephrol Dial Transplant. 2020; 35(9):1619–1628.
[10] Marini JJ, Gattinoni L. Management of COVID-19 Respiratory Distress. JAMA. 2020; 323(22):2329-2330.
[11] Reintam Blaser A, Regli A, De Keulenaer B, Kimball EJ, Starkopf L, Davis WA, et al. Incidence, Risk Factors, and Outcomes of Intra-Abdominal (IROI) Study Investigators. Incidence, Risk Factors, and Outcomes of Intra-Abdominal Hypertension in Critically Ill Patients-A Prospective Multicenter Study (IROI Study). Crit Care Med. 2019; 47(4):535-542.
[12] Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B, et al. Pediatric Guidelines Sub-Committee for the World Society of the Abdominal Compartment Syndrome. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013; 39(7):1190-206.
[13] Doyen D, Dupland P, Morand L, Fourrier E, Saccheri C, Buscot M, et al. Characteristics of cardiac injury in critically ill patients with coronavirus disease 2019. Chest. 2021; 159(5):1974-85.
[14] Ostermann M, Liu K, Kashani K. Fluid Management in Acute Kidney Injury. Chest. 2019; 156(3):594-603.
[15] Regli A, Reintam Blaser A, De Keulenaer B, Starkopf J, Kimball E, Malbrain MLNG, et al. Intra-abdominal hypertension and hypoxic respiratory failure together predict adverse outcome - A sub-analysis of a prospective cohort. J Crit Care. 2021; 64:165-172.
[16] Di Grezia M, Fransvea P, Santullo F, Tirelli F, Fico V, Mirco P, et al. Intra-abdominal hypertension as a trigger of "gut failure" in SARS-CoV-2 infection: Effect of open abdomen (OA) and negative pressure therapy (NPT) on respiratory and gastrointestinal (GI) function. Med Hypotheses. 2020; 144:109954.
[17] Lakshmanan S, Toubia N. Pneumatosis Intestinalis in COVID-19. Clin Gastroenterol Hepatol. 2021; 19(10):e99.
[18] Grieco DL, Menga LS, Eleuteri D, Antonelli M. Patient self-inflicted lung injury: implications for acute hypoxemic respiratory failure and ARDS patients on non-invasive support. Minerva Anestesiol. 2019; 85(9):1014-1023.
Files | ||
Issue | Vol 8 No 1 (2022): Winter | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/aacc.v8i1.8248 | |
Keywords | ||
COVID-19 acute respiratory distress syndrome pulmonary barotrauma |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |