Alessandro Protti1,2, Massimiliano Greco3,2, Matteo Filippini4, Anna M Vilardo5, Thomas Langer6,7, Martina Villa7, Fernando Frutos-Vivar8, Alessandro Santini1, Pier F Caruso1,2, Sofia Spano1,2, Antonio Anzueto9, Giuseppe Citerio7,10, Giacomo Bellani7,11, Giuseppe Foti7,11, Roberto Fumagalli6,7, Antonio Pesenti12,13, Giacomo Grasselli12,13, Maurizio Cecconi1,2. 1. Department of Anesthesiology and Intensive Care Units, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. 2. Humanitas University, Pieve Emanuele, Milan, Italy. 3. Department of Anesthesiology and Intensive Care Units, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy - massimiliano.greco@hunimed.eu. 4. ASST Spedali Civili, Brescia, Italy. 5. ASST Pavia, Ospedale Civile di Voghera, Voghera, Pavia, Italy. 6. ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 7. University of Milano-Bicocca, Milan, Italy. 8. Hospital Universitario de Getafe, Madrid, Spain. 9. University of Texas Health, and South Texas Veterans Health Care System, San Antonio, TX, USA. 10. ASST Monza, Hospital of Desio, Monza, Monza-Brianza, Italy. 11. ASST Monza, San Gerardo Hospital, Monza, Monza-Brianza, Italy. 12. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 13. University of Milan, Milan, Italy.
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 cmH<inf>2</inf>O (2/113 [2%]), a driving airway pressure >15 cmH<inf>2</inf>O (30/113 [27%]), or a tidal volume >8 mL/kg of ideal body weight and a plateau airway pressure >30 cmH<inf>2</inf>O (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.
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 cmH<inf>2</inf>O (2/113 [2%]), a driving airway pressure >15 cmH<inf>2</inf>O (30/113 [27%]), or a tidal volume >8 mL/kg of ideal body weight and a plateau airway pressure >30 cmH<inf>2</inf>O (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.
Authors: Massimiliano Greco; Thomas De Corte; Ari Ercole; Massimo Antonelli; Elie Azoulay; Giuseppe Citerio; Andy Conway Morris; Gennaro De Pascale; Frantisek Duska; Paul Elbers; Sharon Einav; Lui Forni; Laura Galarza; Armand R J Girbes; Giacomo Grasselli; Vitaly Gusarov; Alasdair Jubb; Jozef Kesecioglu; Andrea Lavinio; Maria Cruz Martin Delgado; Johannes Mellinghoff; Sheila Nainan Myatra; Marlies Ostermann; Mariangela Pellegrini; Pedro Povoa; Stefan J Schaller; Jean-Louis Teboul; Adrian Wong; Jan J De Waele; Maurizio Cecconi Journal: Intensive Care Med Date: 2022-05-21 Impact factor: 41.787
Authors: Alessandro Belletti; Gabriele Todaro; Gabriele Valsecchi; Rosario Losiggio; Diego Palumbo; Giovanni Landoni; Alberto Zangrillo Journal: Crit Care Med Date: 2022-03-01 Impact factor: 9.296