2021
DOI: 10.1177/08850666211019719
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Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation

Abstract: Background: We experienced a high incidence of pulmonary barotrauma among patients with coronavirus disease-2019 (COVID-19) associated acute respiratory distress syndrome (ARDS) at our institution. In current study, we sought to estimate the incidence, clinical outcomes, and characteristics of barotrauma among COVID-19 patients receiving invasive and non-invasive positive pressure ventilation. Methodology: We conducted this retrospective cohort study of adult patients diagnosed with COVID-19 pneumonia and requ… Show more

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Cited by 67 publications
(89 citation statements)
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“…impairment of production and/or reabsorption of surfactant due to ATII cell lysis or apoptosis, altered gene expression patterns with evidence for downregulation of surfactant proteins 10 or a combination of several factors. It has been speculated that increased alveolar surface tension due to loss of surfactant may predispose to pulmonary barotrauma, and our findings thus provide a potential mechanism of the higher incidence of subcutaneous emphysema, pneumothorax, and pneumomediastinum in mechanically ventilated CARDS patients (~ 17%) compared to non-COVID ARDS (~ 5–11%) 11 . Furthermore, case series of CARDS patients have reported improvement in oxygenation and lung compliance following exogenous surfactant although repeated doses are probably needed given that ATII cell destruction may predominate in CARDS.…”
Section: Discussionmentioning
confidence: 64%
“…impairment of production and/or reabsorption of surfactant due to ATII cell lysis or apoptosis, altered gene expression patterns with evidence for downregulation of surfactant proteins 10 or a combination of several factors. It has been speculated that increased alveolar surface tension due to loss of surfactant may predispose to pulmonary barotrauma, and our findings thus provide a potential mechanism of the higher incidence of subcutaneous emphysema, pneumothorax, and pneumomediastinum in mechanically ventilated CARDS patients (~ 17%) compared to non-COVID ARDS (~ 5–11%) 11 . Furthermore, case series of CARDS patients have reported improvement in oxygenation and lung compliance following exogenous surfactant although repeated doses are probably needed given that ATII cell destruction may predominate in CARDS.…”
Section: Discussionmentioning
confidence: 64%
“…A higher incidence of barotrauma was observed in COVID-19 ARDS than non-COVID ARDS in some studies, despite the use of lung-protective ventilation strategy in both groups [ 30 ]. The findings of our meta-analysis substantiated the conclusions of the individual studies regarding the increased occurrence of barotrauma in COVID ARDS.…”
Section: Discussionmentioning
confidence: 99%
“… 20 , 48 The total duration of hospitalization for the current case was 19 days, shorter than that in a previous retrospective cohort report. 51 …”
Section: Discussionmentioning
confidence: 99%