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• W3126364578 abstract "To determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS).Observational study.Tertiary-care university hospital.One hundred sixteen consecutive critically ill, invasively ventilated patients with COVID-19 ARDS.The authors collected demographic, mechanical ventilation, imaging, laboratory, and outcome data. Primary outcome was the incidence of PNX/PMD. Multiple logistic regression analyses were performed to identify predictors of PNX/PMD.PNX/PMD occurred in a total of 28 patients (24.1%), with 22 patients developing PNX (19.0%) and 13 developing PMD (11.2%). Mean time to development of PNX/PMD was 14 ± 11 days from intubation. The authors found no significant difference in mechanical ventilation parameters between patients who developed PNX/PMD and those who did not. Mechanical ventilation parameters were within recommended limits for protective ventilation in both groups. Ninety-five percent of patients with PNX/PMD had the Macklin effect (linear collections of air contiguous to the bronchovascular sheaths) on a baseline computed tomography scan, and tended to have a higher lung involvement at intensive care unit (ICU) admission (Radiographic Assessment of Lung Edema score 32.2 ± 13.4 v 18.7 ± 9.8 in patients without PNX/PMD, p = 0.08). Time from symptom onset to intubation and time from total bilirubin on day two after ICU admission were the only independent predictors of PNX/PMD. Mortality was 60.7% in patients who developed PNX/PMD versus 38.6% in those who did not (p = 0.04).PNX/PMD occurs frequently in COVID-19 patients with ARDS requiring mechanical ventilation, and is associated with increased mortality. Development of PNX/PMD seems to occur despite use of protective mechanical ventilation and has a radiologic predictor sign." @default.
• W3126364578 created "2021-02-15" @default.
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• W3126364578 date "2021-12-01" @default.
• W3126364578 modified "2023-10-13" @default.
• W3126364578 title "Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients" @default.
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• W3126364578 doi "https://doi.org/10.1053/j.jvca.2021.02.008" @default.
• W3126364578 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8054543" @default.
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