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Observational Study
. 2023 Apr 27;23(1):138.
doi: 10.1186/s12871-023-02093-1.

Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database

Nicolas Serck  1 , Michael Piagnerelli  2 , Jean Loup Augy  3 , Filippo Annoni  4 , Gregoire Ottavy  5 , Romain Courcelle  6 , Giuseppe Carbutti  7 , Francois Lejeune  8 , Christophe Vinsonneau  9 , Bertrand Sauneuf  10 , Laurent Lefebvre  11 , Julien Higny  12 , David Grimaldi  4 , Jean-Baptiste Lascarrou  13
Affiliations
Observational Study

Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database

Nicolas Serck et al. BMC Anesthesiol. .

Erratum in

Abstract

Background: Despite evidence suggesting a higher risk of barotrauma during COVID-19-related acute respiratory distress syndrome (ARDS) compared to ARDS due to other causes, data are limited about possible associations with patient characteristics, ventilation strategy, and survival.

Methods: This prospective observational multicenter study included consecutive patients with moderate-to-severe COVID-19 ARDS requiring invasive mechanical ventilation and managed at any of 12 centers in France and Belgium between March and December 2020. The primary objective was to determine whether barotrauma was associated with ICU mortality (censored on day 90), and the secondary objective was to identify factors associated with barotrauma.

Results: Of 586 patients, 48 (8.2%) experienced barotrauma, including 35 with pneumothorax, 23 with pneumomediastinum, 1 with pneumoperitoneum, and 6 with subcutaneous emphysema. Median time from mechanical ventilation initiation to barotrauma detection was 3 [0-17] days. All patients received protective ventilation and nearly half (23/48) were in volume-controlled mode. Barotrauma was associated with higher hospital mortality (P < 0.001) even after adjustment on age, sex, comorbidities, PaO2/FiO2 at intubation, plateau pressure at intubation, and center (P < 0.05). The group with barotrauma had a lower mean body mass index (28.6 ± 5.8 vs. 30.3 ± 5.9, P = 0.03) and a higher proportion of patients given corticosteroids (87.5% vs. 63.4%, P = 0.001).

Conclusion: Barotrauma during mechanical ventilation for COVID-19 ARDS was associated with higher hospital mortality.

Keywords: Barotrauma; COVID-19; Mechanical ventilation; Pneumomediastinum; Pneumothorax.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival plots in the groups with and without barotrauma
Fig. 2
Fig. 2
Forest plot of factors analyzed for association with day-90 mortality
See this image and copyright information in PMC

References

    1. CovidTracker. - Suivez l’épidémie de Covid19 en France et dans le monde. CovidTracker. https://covidtracker.fr/. Accessed 19 May 2022.
    1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–20. doi: 10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Kim L, Garg S, O’Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Risk factors for Intensive Care Unit Admission and In-hospital mortality among hospitalized adults identified through the US Coronavirus Disease 2019 (COVID-19)-Associated hospitalization Surveillance Network (COVID-NET) Clin Infect Dis. 2021;72:e206–14. doi: 10.1093/cid/ciaa1012. - DOI - PMC - PubMed
    1. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369:m1985. doi: 10.1136/bmj.m1985. - DOI - PMC - PubMed
    1. Boussarsar M, Thierry G, Jaber S, Roudot-Thoraval F, Lemaire F, Brochard L. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intensive Care Med. 2002;28:406–13. doi: 10.1007/s00134-001-1178-1. - DOI - PubMed

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