%0 Multicenter Study
%T Ventilatory associated barotrauma in COVID-19 patients: A multicenter observational case control study (COVI-MIX-study).
%A Vetrugno L
%A Castaldo N
%A Fantin A
%A Deana C
%A Cortegiani A
%A Longhini F
%A Forfori F
%A Cammarota G
%A Grieco DL
%A Isola M
%A Navalesi P
%A Maggiore SM
%A Bassetti M
%A Chetta A
%A Confalonieri M
%A De Martino M
%A Ferrari G
%A Francisi D
%A Luzzati R
%A Meini S
%A Scozzafava M
%A Sozio E
%A Tascini C
%A Bassi F
%A Patruno V
%A  
%A De Robertis E
%A Aldieri C
%A Ball L
%A Baratella E
%A Bartoletti M
%A Boscolo A
%A Burgazzi B
%A Catalanotti V
%A Confalonieri P
%A Corcione S
%A De Rosa FG
%A De Simoni A
%A Bono VD
%A Tria RD
%A Forlani S
%A Giacobbe DR
%A Granozzi B
%A Labate L
%A Lococo S
%A Lupia T
%A Matellon C
%A Mehrabi S
%A Morosi S
%A Mongodi S
%A Mura M
%A Nava S
%A Pol R
%A Pettenuzzo T
%A Quyen NH
%A Rescigno C
%A Righi E
%A Ruaro B
%A Salton F
%A Scabini S
%A Scarda A
%A Sibani M
%A Tacconelli E
%A Tartaglione G
%A Tazza B
%A Vania E
%A Viale P
%A Vianello A
%A Visentin A
%A Zuccon U
%A Meroi F
%A Buonsenso D
%J Pulmonology
%V 29
%N 6
%D Nov-Dec 2023 24
%M 36669936
暂无%R 10.1016/j.pulmoe.2022.11.002
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.<BR><B>BACKGROUND: </B>this case-control study was prospectively registered in clinicaltrial.gov as NCT04897152 (on 21 May 2021).