1. Barotrauma in mechanically ventilated patients with Coronavirus disease 2019: a survey of 38 hospitals in Lombardy, Italy
- Author
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Antonio Pesenti, Giacomo Bellani, Matteo Filippini, Anna Maria Vilardo, Roberto Fumagalli, Alessandro Santini, Giuseppe Foti, Maurizio Cecconi, Giacomo Grasselli, Sofia Spano, Massimiliano Greco, Thomas Langer, Pier Francesco Caruso, Fernando Frutos-Vivar, Alessandro Protti, Antonio Anzueto, Giuseppe Citerio, Martina Villa, Protti, A, Greco, M, Filippini, M, Vilardo, A, Langer, T, Tavola, M, Frutos-Vivar, F, Santini, A, Caruso, P, Spano, S, Anzueto, A, Citerio, G, Bellani, G, Foti, G, Fumagalli, R, Pesenti, A, Grasselli, G, and Cecconi, M
- Subjects
Adult ,Male ,Critical Care ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,030202 anesthesiology ,law ,Tidal Volume ,Humans ,Medicine ,In patient ,Tidal volume ,Mechanical ventilation ,Air Pressure ,Respiratory Distress Syndrome ,business.industry ,Respiration ,Incidence ,Incidence (epidemiology) ,COVID-19 ,Outbreak ,030208 emergency & critical care medicine ,Middle Aged ,respiratory system ,Respiration, Artificial ,Intensive care unit ,Anesthesiology and Pain Medicine ,Barotrauma ,Italy ,Anesthesia ,Artificial ,Female ,Tomography, X-Ray Computed ,business ,Airway - Abstract
BACKGROUND: The aim was to describe the incidence and risk factors of barotrauma in patients with the Coronavirus disease 2019 (COVID-19) on invasive mechanical ventilation, during the outbreak in our region (Lombardy, Italy). METHODS: The study was an electronic survey open from March 27th to May 2nd, 2020. Patients with COVID-19 who developed barotrauma while on invasive mechanical ventilation from 61 hospitals of the COVID-19 Lombardy Intensive Care Unit network were involved. RESULTS: The response rate was 38/61 (62%). The incidence of barotrauma was 145/2041 (7.1%; 95%-CI: 6.1-8.3%). Only a few cases occurred with ventilatory settings that may be considered non-protective such as a plateau airway pressure >35 cmH2O (2/113 [2%]), a driving airway pressure >15 cmH2O (30/113 [27%]), or a tidal volume >8 mL/kg of ideal body weight and a plateau airway pressure >30 cmH2O (12/134 [9%]). CONCLUSIONS: Within the limits of a survey, patients with COVID-19 might be at high risk for barotrauma during invasive (and allegedly lung-protective) mechanical ventilation.
- Published
- 2021
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