Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation
Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation
复制标题
DOI：
10.1148/radiol.2020202352
复制
发表时间：
2020-11-01
期刊：
影响因子：
19.7
通讯作者：
Moore, William H.
中科院分区：
文献类型：
--
作者：
McGuinness, Georgeann;Zhan, Chenyang;Moore, William H.
背景资料：2019年冠状病毒病患者人数众多目的：确定COVID-19感染患者的气压伤发生率是否高于作者所在机构需要有创机械通气的其他患者材料和方法：在这项回顾性研究中，将2020年3月1日至2020年4月6日期间观察到的COVID-19检测呈阳性并经历了与有创机械通气相关的气压伤的患者的临床和影像学数据与同期未感染COVID-19的患者进行了比较。对作者所在机构2016年2月1日至2020年2月1日急性呼吸窘迫综合征患者的气压伤率进行了历史比较。使用分类或连续统计检验（如适用）以及多变量回归分析对患者组进行比较。结果：共有601例COVID-19感染患者接受了有创机械通气（平均年龄63岁± 15岁[标准差]; 71%为男性）。其中，89例（15%）患者发生了1起或多起气压伤事件，共计145起气压伤事件（24%的总体事件）（95%置信区间[CI]：21%，28%）。在同一时期，196例无COVID-19感染的有创机械通气患者（平均年龄64岁± 19岁; 52%为男性）发生了1起气压伤事件（0.5%; 95% CI：0%，3%; P
Background: A high number of patients with coronavirus disease 2019 (COVID-19) pneumonia who had barotrauma related to invasive mechanical ventilation at the authors' institution were observedPurpose: To determine if the rate of barotrauma in patients with COVID-19 infection was greater than in other patients requiring invasive mechanical ventilation at the authors' institutionMaterials and Methods: In this retrospective study, clinical and imaging data of patients seen between March 1, 2020, and April 6, 2020, who tested positive for COVID-19 and experienced barotrauma associated with invasive mechanical ventilation, were compared with patients without COVID-19 infection during the same period. Historical comparison was made to barotrauma rates of patients with acute respiratory distress syndrome from February 1, 2016, to February 1, 2020, at the authors' institution. Comparison of patient groups was performed using categoric or continuous statistical testing as appropriate, with multivariable regression analysis. Patient survival was assessed using Kaplan-Meier curves analysis.Results: A total of 601 patients with COVID-19 infection underwent invasive mechanical ventilation (mean age, 63 years +/- 15 [standard deviation]; 71% men). Of the total, there were 89 (15%) patients with one or more barotrauma events for a total of 145 barotrauma events (24% overall events) (95% confidence interval [CI]: 21%, 28%). During the same period, 196 patients without COVID-19 infection (mean age, 64 years +/- 19; 52% men) with invasive mechanical ventilation had one barotrauma event (0.5%; 95% CI: 0%, 3%; P