The goal of the study was to determine if patients with respiratory failure due to COVID-19 admitted to ICU had an a) increased incidence of barotrauma in both ventilated and non-ventilated patients, b) was barotrauma associated with worse outcome (mortality, LOS in ICU and LOS in the hospital). Additionally, there have been reports of barotrauma in patients with COVID-19 requiring high flow nasal cannula or non-invasive ventilatory support. However, these studies only included patients on invasive mechanical ventilation. A recent study showed an increased incidence of barotrauma in patients with COVID-19 related ARDS, as well as associations with increased mortality and hospital length of stay (LOS). Interestingly, patients with acute respiratory failure due to COVID-19 have been observed to have higher rates of barotrauma. Since the institution of lung-protective ventilatory strategies outlined in the ARDSnet protocols, the prevalence of barotrauma in patients with ARDS is reported at 4–11%. Lung protective strategies are essential to prevent barotrauma. Determinants of barotrauma include transpulmonary pressures, tidal volume and presence and degree of dynamic hyperinflation. The diagnosis of barotrauma is both clinical and radiological, with complications ranging from pneumothorax, pneumomediastinum, to subcutaneous emphysema. Of these, ventilator-induced lung injury and barotrauma have been of increasing interest. Given the significant rise in the caseload of acute respiratory distress syndrome (ARDS) and widespread requirement of ventilatory support, the consequences of invasive ventilation and disease-specific factors are of particular importance. Since December 31, 2019, when China reported a series of cases of acute respiratory failure caused by a new species of coronavirus, SARS-CoV-2, more than 50 million new cases, and almost 1,260,000 deaths have been confirmed worldwide. Contact information: Jesse Thompson, MS, PhD Data Manager Associate Co-Director WVCTSI FRA West Virginia University The author(s) received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭhronic obstructive pulmonary disease SOFA, Data are available from the WVU Institutional Data Access / Ethics Committee (contact via email) for researchers who meet the criteria for access to confidential data. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data cannot be shared publicly because of protected patient information. Received: OctoAccepted: FebruPublished: March 9, 2023Ĭopyright: © 2023 Sharma et al. PLoS ONE 18(3):Įditor: Samuele Ceruti, Sant Anna Hospital: Clinica Sant’Anna, SWITZERLAND (2023) High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study. Citation: Sharma S, Badami V, Rojas E, Sangani R, Chapman K, Avalon C, et al.
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