Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients.

摘要: Objective To determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). Design Observational study. Setting Tertiary-care university hospital. Participants One hundred sixteen consecutive critically ill, invasively ventilated patients with COVID-19 ARDS. Interventions The authors collected demographic, mechanical ventilation, imaging, laboratory, data. Primary was incidence PNX/PMD. Multiple logistic regression analyses were performed to identify predictors Measurements Main Results PNX/PMD occurred a total 28 (24.1%), 22 developing PNX (19.0%) 13 PMD (11.2%). Mean time development 14 ± 11 days from intubation. found no significant difference ventilation parameters between who developed those did not. Mechanical within recommended limits for protective both groups. Ninety-five percent had Macklin effect (linear collections air contiguous bronchovascular sheaths) on baseline computed tomography scan, tended have higher lung involvement at intensive care unit (ICU) admission (Radiographic Assessment Lung Edema score 32.2 13.4 v 18.7 9.8 without PNX/PMD, p = 0.08). Time symptom onset intubation bilirubin day two after ICU only independent Mortality 60.7% versus 38.6% not (p = 0.04). Conclusion occurs frequently ARDS requiring is associated increased mortality. Development seems occur despite use has radiologic predictor sign.