![]() ![]() The hospital's institutional ethics committee granted clearance for the project. The goal of the study was to see how COVID-19 affects the clinical course and prognosis of barotrauma-related ailments.īetween March 2021 and June 2021, a retrospective research was conducted at the Kalinga Institute of Medical Sciences in India. The objective of our study was to identify clinical features and risk factors associated with the development of barotrauma in COVID-19 patients who were mechanically ventilated. These patients frequently require a high level of PEEP to maintain oxygenation, putting them at risk for barotrauma. In mechanical ventilation, PBT refers to alveolar rupture caused by increased transalveolar pressure (the alveolar pressure minus the pressure in the adjacent interstitial space), which causes air leaks into extra-alveolar tissue, resulting in pneumothorax, pneumomediastinum, pneumoperitoneum, and subcutaneous emphysema (Udi et al. To ensure adequate oxygenation, PEEP might be raised at the risk of increased Pplat and barotrauma. In trials, higher PEEP techniques have been shown to improve survival in ARDS patients at the expense of an increased risk of pneumothorax (Briel et al. During the COVID pandemic, extrinsic PEEP has been utilised in ARDS to improve oxygenation, lower oxygen demand (FiO2), and minimise atelectotrauma (repeated opening and closing of alveoli), all of which helped to prevent ventilator-induced lung damage (Alhazzani et al. Limiting lung damage to plateau pressures (Pplat) of less than 30 cm H2O is another lung-protective strategy, since Pplat > 32 has been associated with higher short-term mortality (Yasuda et al. Low Vt (4–8 ml/kg) is suggested by numerous standards, including the COVID-19 guidelines from the last surviving sepsis campaign, since it is considered to decrease volutrauma in ARDS patients' lungs (Alhazzani et al. Using a low tidal volume (Vt) and a high positive end-expiratory pressure (PEEP) in patients with ARDS has been shown in several trials to minimise hospital mortality (Walkey et al. It has its own set of hazards and consequences, including pulmonary barotrauma (PBT) and ventilator-induced lung injury, both of which have been related to multisystem organ failure in ARDS patients (Slutsky and Ranieri 2013 Nov 28). Patients with ARDS and COVID can benefit from positive pressure ventilation (PPV), which is a non-physiological and invasive/non-invasive approach that can save their lives. In mechanically ventilated patients, the relationship between acute respiratory distress syndrome (ARDS) and subsequent pneumothorax has long been recognised as a risk factor for fatality (Huang et al. Recent studies have found that barotrauma-related issues caused by invasive mechanical ventilation are becoming increasingly prevalent, with up to 15% of COVID-19 patients experiencing them (Bajema et al. WHO Director-General’s remarks at the media briefing 2020 Chan et al. In COVID-19 patients in the intensive care unit (ICU), pneumothorax is reported to occur at a rate of 2% (World Health Organization 2. This highly transmissible and contagious disease affects a variety of systems, including the respiratory tract. WHO Director-General’s remarks at the media briefing 2020). As a result, the death rate in this patient group is higher.ĬOVID-19, a novel coronavirus, has spread around the world (World Health Organization 2. Patients infected with COVID-19 have a high risk of barotrauma when on mechanical ventilation. There were no statistically significant differences in CRP, procalcitonin, d-dimer test, LDH, or ferritin. ![]() In patients with and without barotrauma, significant factors were white blood cell count ( p = 0.001), neutrophil percentage ( p = 0.012), and lymphocyte percentage ( p = 0.014). Of those that developed barotrauma, 45 (93.7%) patients were in acute respiratory distress syndrome. Out of 48 patients who developed barotrauma, 30 (62.5%) presented with pneumothorax, 22 (45.8%) with pneumomediastinum, 10 (20.8%) with subcutaneous emphysema, and 2 (4.1%) with pneumopericardium. This study aimed to explore the possibility of developing the barotrauma-related issues with mechanical ventilation in the cases of individuals suffering from COVID-19. The development of barotrauma in COVID-19 patients who were ventilated and admitted to the intensive treatment unit seemed to have been a problematic issue in the COVID era. ![]()
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