Ventilatory associated barotrauma in COVID-19 patients: A multicenter observational case control study (COVI-MIX-study).

Autor:	Vetrugno L; Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. Electronic address: luigi.vetrugno@unich.it., Castaldo N; Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Fantin A; Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., Deana C; Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy., Cortegiani A; Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy; Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy., Longhini F; Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy., Forfori F; Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, AOUP-Pisa, Italy., Cammarota G; Anesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy., Grieco DL; Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy; Department of Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Isola M; Department of Medicine, University of Udine, Udine, Italy., Navalesi P; Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy; Department of Medicine (DIMED), University of Padua, Padua, Italy., Maggiore SM; Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, Chieti, Italy., Bassetti M; Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy., Chetta A; Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy., Confalonieri M; Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy., De Martino M; Department of Medicine, University of Udine, Udine, Italy., Ferrari G; Pneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy., Francisi D; Department of Infectious Disease 'S. Maria della Misericordia' Hospital, University of Perugia, Perugia, Italy., Luzzati R; Infectious Disease Unit, University of Trieste, Trieste, Italy., Meini S; U.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy., Scozzafava M; Respiratory High Dependecy Unit - General Hospital Lodi, Lodi, Italy., Sozio E; Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy., Tascini C; Department of Medicine, University of Udine, Udine, Italy; Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy., Bassi F; Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy., Patruno V; Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy., De Robertis E; Anesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy., Aldieri C; Division of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy., Ball L; Anesthesia and Intensive Care, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy., Baratella E; Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy., Bartoletti M; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy., Boscolo A; Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy., Burgazzi B; Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy., Catalanotti V; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy., Confalonieri P; Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy., Corcione S; Department of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy., De Rosa FG; Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy; Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy., De Simoni A; Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy., Bono VD; Division of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy., Tria RD; Pneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy., Forlani S; Pulmonary Medicine Unit, Lodi General Hospital, Lodi, Italy., Giacobbe DR; Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy., Granozzi B; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy., Labate L; Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy., Lococo S; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy., Lupia T; Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy., Matellon C; Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy., Mehrabi S; Infectious Diseases Division, Diagnostics and Public Health Department, University of Verona, Verona, Italy., Morosi S; Department of Infectious Disease 'S. Maria della Misericordia' Hospital, University of Perugia, Perugia, Italy., Mongodi S; Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Mura M; U.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy., Nava S; Department of Clinical, Integrated and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy; Respiratory and Critical Care Unit, Sant Orsola University Hospital, Bologna, Italy., Pol R; Infectious Disease Unit, University of Trieste, Trieste, Italy., Pettenuzzo T; Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy., Quyen NH; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Rescigno C; UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy., Righi E; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Ruaro B; Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy., Salton F; Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy., Scabini S; Department of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy., Scarda A; Respiratory Disease Unit, 'Santa Maria degli Angeli' Hospital, Pordenone, Italy., Sibani M; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Tacconelli E; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Tartaglione G; Respiratory Disease Unit, 'Santa Maria degli Angeli' Hospital, Pordenone, Italy., Tazza B; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy., Vania E; Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy., Viale P; Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy., Vianello A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Visentin A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Zuccon U; Respiratory Disease Unit, 'Santa Maria degli Angeli' Hospital, Pordenone, Italy., Meroi F; Department of Medicine, University of Udine, Udine, Italy., Buonsenso D; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Pulmonology [Pulmonology] 2023 Nov-Dec; Vol. 29 (6), pp. 457-468. Date of Electronic Publication: 2022 Nov 24.
DOI:	10.1016/j.pulmoe.2022.11.002
Abstrakt:	Background: The risk of barotrauma associated with different types of ventilatory support is unclear in COVID-19 patients. The primary aim of this study was to evaluate the effect of the different respiratory support strategies on barotrauma occurrence; we also sought to determine the frequency of barotrauma and the clinical characteristics of the patients who experienced this complication. Methods: This multicentre retrospective case-control study from 1 March 2020 to 28 February 2021 included COVID-19 patients who experienced barotrauma during hospital stay. They were matched with controls in a 1:1 ratio for the same admission period in the same ward of treatment. Univariable and multivariable logistic regression (OR) were performed to explore which factors were associated with barotrauma and in-hospital death. Results: We included 200 cases and 200 controls. Invasive mechanical ventilation was used in 39.3% of patients in the barotrauma group, and in 20.1% of controls (p<0.001). Receiving non-invasive ventilation (C-PAP/PSV) instead of conventional oxygen therapy (COT) increased the risk of barotrauma (OR 5.04, 95% CI 2.30 - 11.08, p<0.001), similarly for invasive mechanical ventilation (OR 6.24, 95% CI 2.86-13.60, p<0.001). High Flow Nasal Oxygen (HFNO), compared with COT, did not significantly increase the risk of barotrauma. Barotrauma frequency occurred in 1.00% [95% CI 0.88-1.16] of patients; these were older (p=0.022) and more frequently immunosuppressed (p=0.013). Barotrauma was shown to be an independent risk for death (OR 5.32, 95% CI 2.82-10.03, p<0.001). Conclusions: C-PAP/PSV compared with COT or HFNO increased the risk of barotrauma; otherwise HFNO did not. Barotrauma was recorded in 1.00% of patients, affecting mainly patients with more severe COVID-19 disease. Barotrauma was independently associated with mortality. Trial Registration: this case-control study was prospectively registered in clinicaltrial.gov as NCT04897152 (on 21 May 2021). Competing Interests: Declaration of Competing Interest None. (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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