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

作者：Luigi Vetrugno, Nadia Castaldo, A. Fantin, C. Deana, A. Cortegiani, F. Longhini, F. Forfori, G. Cammarota, D. Grieco, M. Isola, P. Navalesi, S. Maggiore, M. Bassetti, A. Chetta, M. Confalonieri, M. De Martino, G. Ferrari, Daniela Francisi, R. Luzzati, S. Meini, M. Scozzafava, E. Sozio, C. Tascini, F. Bassi, V. Patruno, E. de Robertis, Chiara Aldieri, L. Ball, E. Baratella, M. Bartoletti, A. Boscolo, Barbara Burgazzi, V. Catalanotti, P. Confalonieri, S. Corcione, F. D. De Rosa, A. De Simoni, V. Del Bono, R. Di Tria, S. Forlani, D. Giacobbe, Bianca Granozzi, L. Labate, S. Lococo, T. Lupia, Carola Matellon, S. Mehrabi, Sabrina Morosi, S. Mongodi, Maddalena Mura, S. Nava, Riccardo Pol, T. Pettenuzzo, Quyen Hoang Nguyen, C. Rescigno, E. Righi, B. Ruaro, F. Salton, S. Scabini, A. Scarda, M. Sibani, E. Tacconelli, Gennaro Tartaglione, B. Tazza, E. Vania, P. Viale, A. Vianello, A. Visentin, U. Zuccon, F. Meroi, D. Buonsenso · 发表于：Pulmonology · 年份：2022 · DOI：10.1016/j.pulmoe.2022.11.002 · 被引用次数：41 · 研究领域：Medicine

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). Baro...