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Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study.
- Source :
-
Respiratory medicine [Respir Med] 2021 Aug; Vol. 184, pp. 106464. Date of Electronic Publication: 2021 May 13. - Publication Year :
- 2021
-
Abstract
- Background: The clinical features and outcomes of mechanically ventilated patients with COVID-19 infection who develop a pneumothorax has not been rigorously described or compared to those who do not develop a pneumothorax.<br />Purpose: To determine the incidence, clinical characteristics, and outcomes of critically ill patients with COVID-19 infection who developed pneumothorax. In addition, we compared the clinical characteristics and outcomes of mechanically ventilated patients who developed a pneumothorax with those who did not develop a pneumothorax.<br />Methods: This study was a multicenter retrospective analysis of all adult critically ill patients with COVID-19 infection who were admitted to intensive care units in 4 tertiary care centers in the United States.<br />Results: A total of 842 critically ill patients with COVID-19 infection were analyzed, out of which 594 (71%) were mechanically ventilated. The overall incidence of pneumothorax was 85/842 (10%), and 80/594 (13%) in those who were mechanically ventilated. As compared to mechanically ventilated patients in the non-pneumothorax group, mechanically ventilated patients in the pneumothorax group had worse respiratory parameters at the time of intubation (mean PaO <subscript>2</subscript> :FiO <subscript>2</subscript> ratio 105 vs 150, P<0.001 and static respiratory system compliance: 30ml/cmH <subscript>2</subscript> O vs 39ml/cmH <subscript>2</subscript> O, P = 0.01) and significantly higher in-hospital mortality (63% vs 49%, P = 0.04).<br />Conclusion: The overall incidence of pneumothorax in mechanically ventilated patients with COVID-19 infection was 13%. Mechanically ventilated patients with COVID-19 infection who developed pneumothorax had worse gas exchange and respiratory mechanics at the time of intubation and had a higher mortality compared to those who did not develop pneumothorax.<br /> (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
COVID-19 mortality
COVID-19 physiopathology
COVID-19 therapy
Case-Control Studies
Female
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Multicenter Studies as Topic
Pneumothorax epidemiology
Pneumothorax mortality
Pneumothorax physiopathology
Prognosis
Pulmonary Gas Exchange
Retrospective Studies
Risk Factors
COVID-19 complications
Critical Illness
Pneumothorax etiology
Respiration, Artificial adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3064
- Volume :
- 184
- Database :
- MEDLINE
- Journal :
- Respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34044224
- Full Text :
- https://doi.org/10.1016/j.rmed.2021.106464