8 Survival rate from all 20 patients was 65%, whereas survival rate from patients with barotrauma was 75%, indicating that in most cases barotrauma could successfully be managed and was not an inevitable cause of death in our cohort of patients. ![]() It has also been proposed that development of spontaneous pneumomediastinum and subcutaneous emphysema might be a disease specific complication of viral pneumonia. While it seems counterintuitive that barotrauma is not associated with increased positive pressure ventilation, it can be argued that high pressures for example during coughing are triggers for barotrauma and not recorded adequately. 11 found that higher PEEP was related to an increased risk of barotrauma. 3 While some authors argued that the development of barotrauma is not related to the ventilator airway pressures and tidal volumes, 10 other groups like Eisner et al. found no correlation between barotrauma and MV settings. Whether the development of barotrauma during invasive MV is associated or not with MV parameters has been controversially discussed. We defined presence of pneumothorax, pneumomediastinum or pneumopericard in absence of a preceding intervention with the risk of pulmonary complications (like cannulation for a central venous catheter) as barothauma or VILI. Barotrauma was detected by manual review of all radiological investigations performed in our COVID-19 patients. Of these 56 ARDS patients, 25 were transferred from a smaller hospital to our ARDS center. ![]() Within this time period, a total of 198 SARS-CoV-2 positive patients were treated at our hospital, from which 67 patients were on intensive care unit and 56 underwent mechanical ventilation for COVID-19 ARDS. Patients with high clinical probability of COVID-19 infection but negative SARS-CoV-2 PCR testing were therefore excluded. 2 Only patients with PCR-confirmed SARS-CoV-2 infection were considered, with PCR (polymerase chain reaction) tests either processing nasopharyngeal swabs or tracheal secretion. In the present case-control study, we included all COVID-19 patients on mechanical ventilation treated at the medical ICU between 03/2020 and 04/2020 that fulfilled criteria for the diagnosis of ARDS according to the “Berlin Definition of ARDS”: 1.) Onset within 1 week of a known clinical insult or new or worsening respiratory symptoms 2.) Presence of bilateral opacities in the chest imaging 3.) Respiratory failure not fully explained by cardiac failure or fluid overload 4) Hypoxemia (with the corresponding subclassification in mild, moderate and severe ARDS). All subjects Allied Health Cardiology & Cardiovascular Medicine Dentistry Emergency Medicine & Critical Care Endocrinology & Metabolism Environmental Science General Medicine Geriatrics Infectious Diseases Medico-legal Neurology Nursing Nutrition Obstetrics & Gynecology Oncology Orthopaedics & Sports Medicine Otolaryngology Palliative Medicine & Chronic Care Pediatrics Pharmacology & Toxicology Psychiatry & Psychology Public Health Pulmonary & Respiratory Medicine Radiology Research Methods & Evaluation Rheumatology Surgery Tropical Medicine Veterinary Medicine Cell Biology Clinical Biochemistry Environmental Science Life Sciences Neuroscience Pharmacology & Toxicology Biomedical Engineering Engineering & Computing Environmental Engineering Materials Science Anthropology & Archaeology Communication & Media Studies Criminology & Criminal Justice Cultural Studies Economics & Development Education Environmental Studies Ethnic Studies Family Studies Gender Studies Geography Gerontology & Aging Group Studies History Information Science Interpersonal Violence Language & Linguistics Law Management & Organization Studies Marketing & Hospitality Music Peace Studies & Conflict Resolution Philosophy Politics & International Relations Psychoanalysis Psychology & Counseling Public Administration Regional Studies Religion Research Methods & Evaluation Science & Society Studies Social Work & Social Policy Sociology Special Education Urban Studies & Planning BROWSE JOURNALS
0 Comments
Leave a Reply. |