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