التفاصيل البيبلوغرافية
| العنوان: |
Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients |
| المؤلفون: |
Alessandro Belletti, Giordano Vitali, Lorenzo Dagna, Francesco De Cobelli, Nicolò Maimeri, Giacomo Monti, Antonio Dell'Acqua, Diego Palumbo, Sergio Colombo, Carolina Faustini, Anna Mara Scandroglio, Alberto Zangrillo, Giorgia Guazzarotti, Rosalba Lembo, Stefano Franchini, Giovanni Landoni, Alessandro Marinosci, Junaid Mushtaq, Renato Pennella, Evgeny Fominskiy |
| المساهمون: |
Belletti, A., Palumbo, D., Zangrillo, A., Fominskiy, E. V., Franchini, S., Dell'Acqua, A., Marinosci, A., Monti, G., Vitali, G., Colombo, S., Guazzarotti, G., Lembo, R., Maimeri, N., Faustini, C., Pennella, R., Mushtaq, J., Landoni, G., Scandroglio, A. M., Dagna, L., De Cobelli, F. |
| المصدر: |
Journal of Cardiothoracic and Vascular Anesthesia |
| بيانات النشر: |
Elsevier BV, 2021. |
| سنة النشر: |
2021 |
| مصطلحات موضوعية: |
ARDS, pneumothorax, medicine.medical_treatment, mechanical ventilation, 030204 cardiovascular system & hematology, barotrauma, Logistic regression, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Macklin effect, medicine, Humans, Intubation, Pneumomediastinum, Mediastinal Emphysema, Original Research, Mechanical ventilation, SARS-CoV-2, business.industry, Incidence (epidemiology), COVID-19, acute respiratory distress syndrome, medicine.disease, Respiration, Artificial, Intensive care unit, Anesthesiology and Pain Medicine, Pneumothorax, Anesthesia, business, Cardiology and Cardiovascular Medicine |
| الوصف: |
Objective To determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). Design Observational study. Setting Tertiary-care university hospital. Participants One hundred sixteen consecutive critically ill, invasively ventilated patients with COVID-19 ARDS. Interventions The authors collected demographic, mechanical ventilation, imaging, laboratory, and outcome data. Primary outcome was the incidence of PNX/PMD. Multiple logistic regression analyses were performed to identify predictors of PNX/PMD. Measurements and Main Results PNX/PMD occurred in a total of 28 patients (24.1%), with 22 patients developing PNX (19.0%) and 13 developing PMD (11.2%). Mean time to development of PNX/PMD was 14 ± 11 days from intubation. The authors found no significant difference in mechanical ventilation parameters between patients who developed PNX/PMD and those who did not. Mechanical ventilation parameters were within recommended limits for protective ventilation in both groups. Ninety-five percent of patients with PNX/PMD had the Macklin effect (linear collections of air contiguous to the bronchovascular sheaths) on a baseline computed tomography scan, and tended to have a higher lung involvement at intensive care unit (ICU) admission (Radiographic Assessment of Lung Edema score 32.2 ± 13.4 v 18.7 ± 9.8 in patients without PNX/PMD, p = 0.08). Time from symptom onset to intubation and time from total bilirubin on day two after ICU admission were the only independent predictors of PNX/PMD. Mortality was 60.7% in patients who developed PNX/PMD versus 38.6% in those who did not (p = 0.04). Conclusion PNX/PMD occurs frequently in COVID-19 patients with ARDS requiring mechanical ventilation, and is associated with increased mortality. Development of PNX/PMD seems to occur despite use of protective mechanical ventilation and has a radiologic predictor sign. |
| اللغة: |
English |
| تدمد: |
1053-0770 |
| DOI: |
10.1053/j.jvca.2021.02.008 |
| URL الوصول: |
https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ed5a3a9083f20f4019b5ca0e3f123dc8 |
| Rights: |
OPEN |
| رقم الانضمام: |
edsair.doi.dedup.....ed5a3a9083f20f4019b5ca0e3f123dc8 |
| قاعدة البيانات: |
OpenAIRE |