1,184 results match your criteria Barotrauma and Mechanical Ventilation

Barotrauma in COVID 19: Incidence, pathophysiology, and effect on prognosis.

Clin Imaging 2022 Jun 28;90:71-77. Epub 2022 Jun 28.

Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, New York, NY 10029, United States of America.

Objectives: To investigate the incidence, risk factors, and outcomes of barotrauma (pneumomediastinum and subcutaneous emphysema) in mechanically ventilated COVID-19 patients. To describe the chest radiography patterns of barotrauma and understand the development in relation to mechanical ventilation and patient mortality.

Methods: We performed a retrospective study of 363 patients with COVID-19 from March 1 to April 8, 2020. Read More

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Low tidal volume ventilation alleviates ventilator-induced lung injury by regulating the NLRP3 inflammasome.

Exp Lung Res 2022 Aug 2:1-10. Epub 2022 Aug 2.

Department of Vascular and Thyroid Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

Purpose: Low tidal volume ventilation (LTVV) is a well-known ventilation mode which can improve ventilator-induced lung injury (VILI). However, the mechanism of LTVV ameliorating VILI has not yet been elucidated. In this study, we aimed to reveal LTVV protected against VILI by inhibiting the activation of the NLRP3 inflammasome in bronchoalveolar lavage fluid (BALF) from humans and lungs from mice. Read More

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Pulmonary Barotrauma in COVID-19 Patients: Experience From a Secondary Care Hospital in Oman.

Cureus 2022 Jun 29;14(6):e26414. Epub 2022 Jun 29.

Anesthesiology, Ibra Hospital, Ibra, OMN.

Background During the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients developed pulmonary barotrauma either self-inflicted or ventilator-induced. In pulmonary barotrauma, air leaks into extra-alveolar tissue resulting in pneumomediastinum, subcutaneous emphysema, pneumothorax, and pneumoperitoneum. Methods After obtaining institutional approval, we retrospectively reviewed data from March 1, 2021, to September 31, 2021. Read More

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Intraoperative protective lung ventilation strategies in patients with morbid obesity.

Saudi J Anaesth 2022 Jul-Sep;16(3):327-331. Epub 2022 Jun 20.

Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA.

Postoperative pulmonary complications (PPCs) occur frequently and are associated with a prolonged hospital stay, increased mortality, and high costs. Patients with morbid obesity are at higher risk of perioperative complications, in particular associated with those related to respiratory function. One of the most prominent concerns of the anesthesiologists while taking care of the patient with obesity in the perioperative setting should be the status of the lung and delivery of mechanical ventilation as its strategy affects clinical outcomes. Read More

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Limitation of tube thoracostomy in treating pneumothorax in COVID-19 infected patients. A retrospective cohort study.

Ann Med Surg (Lond) 2022 Aug 18;80:104171. Epub 2022 Jul 18.

School of Medicine, University of Jordan, Jordan.

Background: COVID infection is caused by the highly contagious SARS-CoV-2(Severe acute respiratory syndrome coronavirus 2). The first outbreak of this infection was in Wuhan, China in December 2019. Since then, it has spread rapidly across the world, with more than 100000 new cases each day. Read More

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Complications of invasive mechanical ventilation in critically Ill Covid-19 patients - A narrative review.

Ann Med Surg (Lond) 2022 Aug 16;80:104201. Epub 2022 Jul 16.

Department of Internal Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi, 74200, Pakistan.

Critically ill COVID-19 patients have to undergo positive pressure ventilation, a non-physiological and invasive intervention that can be lifesaving in severe ARDS. Similar to any other intervention, it has its pros and cons. Despite following Lung Protective Ventilation (LPV), some of the complications are frequently reported in these critically ill patients and significantly impact overall mortality. Read More

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Barotrauma and its complications in COVID-19 patients: a retrospective study at tertiary care hospital of Eastern India.

Bull Natl Res Cent 2022 15;46(1):212. Epub 2022 Jul 15.

Department of Community Medicine, Kalinga Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha India.

Background: The development of barotrauma in COVID-19 patients who were ventilated and admitted to the intensive treatment unit seemed to have been a problematic issue in the COVID era. This study aimed to explore the possibility of developing the barotrauma-related issues with mechanical ventilation in the cases of individuals suffering from COVID-19.

Results: Out of 48 patients who developed barotrauma, 30 (62. Read More

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Efficacy and Safety of Cisatracurium Compared to Vecuronium for Neuromuscular Blockade in Acute Respiratory Distress Syndrome.

J Intensive Care Med 2022 Jul 12:8850666221113504. Epub 2022 Jul 12.

Department of Pharmacy, 41528UMass Memorial Medical Center, Worcester, MA, USA.

Purpose: Previous studies analyzing neuromuscular blocking agents (NMBAs) in acute respiratory distress syndrome (ARDS) have evaluated the benefit of cisatracurium with conflicting results, and data evaluating other NMBAs remains limited. The objective of this study was to compare the efficacy and safety of cisatracurium to vecuronium in ARDS.

Materials And Methods: A single-center, retrospective, propensity matched review of patients who received cisatracurium or vecuronium continuous infusions between October 1, 2017 and June 30, 2020 for ARDS was conducted. Read More

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Unusual complications of non-invasive mechanical ventilation (NIV) and high-flow nasal cannula (HFNC): A systematic review.

Tuberk Toraks 2022 06;70(2):197-202

Pulmonary Critical Care Division Lenox Hill Hospital, New York, USA.

The first application of modern non-invasive mechanical ventilation (NIV) can be traced back to over 30 years ago when a patient suffering from Duchenne Muscular Dystrophy was successfully ventilated. Since then, the use of NIV has been on the rise throughout the world. Although a very modern and safe therapy, complications during its application are inevitable. Read More

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Airway Pressure Release Ventilation for Acute Respiratory Failure Due to Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.

J Intensive Care Med 2022 Jun 22:8850666221109779. Epub 2022 Jun 22.

Alhayat Clinic, Edku, el-Beheira, Egypt.

Objective: To explore the evidence surrounding the use of Airway Pressure Release Ventilation (APRV) in patients with coronavirus disease 2019 (COVID-19). A Systematic electronic search of PUBMED, EMBASE, and the WHO COVID-19 database. We also searched the grey literature via Google and preprint servers (medRxive and research square). Read More

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High-Frequency Oscillatory Ventilation for Refractory Hypoxemia in Severe COVID-19 Pneumonia: A Small Case Series.

Am J Case Rep 2022 Jun 22;23:e936651. Epub 2022 Jun 22.

Department of Critical Care Medicine, Lexington Medical Center, West Columbia, SC, USA.

BACKGROUND COVID-19 continues to place a tremendous burden on the healthcare system, with most deaths resulting from respiratory failure. Management strategies have varied, but the mortality rate for mechanically ventilated patients remains high. Conventional management with ARDSnet ventilation can improve outcomes but alternative and adjunct treatments continue to be explored. Read More

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Clinical Profile of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection Developing Pulmonary Barotrauma on Mechanical Ventilation.

Indian J Crit Care Med 2022 May;26(5):613-618

Sir HN Medical Research Society, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India.

Background: There is limited information on clinical profile and outcomes of patients on mechanical ventilation (MV) who developed pulmonary barotrauma (PBT) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Patients And Methods: In a retrospective observational study, all SARS-CoV-2 pneumonia patients admitted from March 28, 2020, to August 31, 2020, at Sir HN Reliance Foundation Hospital and Research Center and Seven Hills Hospital (Reliance Facility), Mumbai, India, of 18 years and above on MV and developed PBT, were included.

Results: A total of 14 SARS-CoV-2 patients of 45 on MV (31. Read More

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Study protocol for a single-centre randomised controlled trial to investigate the effect of lung recruitment in paediatric patients after cardiac surgery.

BMJ Open 2022 05 17;12(5):e063278. Epub 2022 May 17.

Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.

Introduction: A number of published studies have revealed that lung recruitment can improve oxygenation, shorten the duration of mechanical ventilation (MV) and decrease mortality in adults with acute hypoxaemic respiratory failure, especially patients with acute respiratory distress syndrome. However, few articles have assessed lung recruitment in paediatric patients, especially after cardiac surgery. This clinical trial aimed to determine whether lung recruitment can reduce the duration of MV in paediatric patients with hypoxaemic respiratory failure after cardiac surgery. Read More

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Venovenous Extracorporeal Membrane Oxygenation in Awake Non-Intubated Patients With COVID-19 ARDS at High Risk for Barotrauma.

J Cardiothorac Vasc Anesth 2022 08 17;36(8 Pt B):2975-2982. Epub 2022 Mar 17.

Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. Electronic address:

Objectives: To assess the efficacy of an awake venovenous extracorporeal membrane oxygenation (VV-ECMO) management strategy in preventing clinically relevant barotrauma in patients with coronavirus disease 2019 (COVID-19) with severe acute respiratory distress syndrome (ARDS) at high risk for pneumothorax (PNX)/pneumomediastinum (PMD), defined as the detection of the Macklin-like effect on chest computed tomography (CT) scan.

Design: A case series.

Setting: At the intensive care unit of a tertiary-care institution. Read More

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Macklin effect on baseline chest CT scan accurately predicts barotrauma in COVID-19 patients.

Respir Med 2022 06 20;197:106853. Epub 2022 Apr 20.

Department of Anesthesia e Critical Care Medicine, Cardiothoracic-Vascular Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Italy.

Purpose: To validate the role of Macklin effect on chest CT imaging in predicting subsequent occurrence of pneumomediastinum/pneumothorax (PMD/PNX) in COVID-19 patients.

Materials And Methods: This is an observational, case-control study. Consecutive COVID-19 patients who underwent chest CT scan at hospital admission during the study time period (October 1st, 2020-April 31st, 2021) were identified. Read More

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Aspergilloma complicating previous COVID-19 pneumonitis - a case report.

APMIS 2022 Jul 16;130(7):397-403. Epub 2022 May 16.

Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

Aspergillomas are found in pre-existing cavities in pulmonary parenchyma. To the best of our knowledge, aspergilloma has not previously been reported in COVID-19-associated pulmonary architecture distortion combined with barotrauma from invasive mechanical ventilation therapy. We present a case of a 67-year-old woman, who suffered from severe COVID-19 in the summer of 2020 with no suspicion of infection with Aspergillus in the acute phase. Read More

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Incidence, clinical characteristics and outcome of barotrauma in critically ill patients with COVID-19: a systematic review and meta-analysis.

Minerva Anestesiol 2022 09 13;88(9):706-718. Epub 2022 Apr 13.

Unit of Anesthesia and Resuscitation II, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy.

Introduction: Barotrauma is rare in patients with acute respiratory distress syndrome undergoing mechanical ventilation. Its incidence seems increased among critically ill COVID-19 patients. We performed a systematic review and meta-analysis to investigate the incidence, risk factors and clinical outcomes of barotrauma among critically ill COVID-19 patients. Read More

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September 2022

Barotrauma in critically ill COVID-19 patients: a retrospective case-control study.

Anaesthesiol Intensive Ther 2022 ;54(1):18-22

All India Institute of Medical Sciences, Delhi.

Background: There is increased incidence of barotrauma in COVID-19 patients, probably due to disease pathology, oxygen therapy and coughing. We aimed to retrospectively compare the characteristics, associations and outcomes of COVID-19 patients with and without barotrauma in the intensive care unit (ICU).

Methods: All adults admitted between October 1st and December 31st 2020 in the ICUs of a COVID-19 hospital were retrospectively analysed for presence of a 'barotrauma event' (presence of at least one of pneumothorax, pneumomediastinum, subcutaneous emphysema or bronchopleural fistula). Read More

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Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery.

BMC Anesthesiol 2022 03 18;22(1):73. Epub 2022 Mar 18.

Department of Anesthesiology and Pain Medicine, 108 Military Central Hospital, No.1 Tran Hung Dao Street, Hai Ba Trung District, Ha Noi City, 100000, Vietnam.

Background: Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient's same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apneic conditions with high-flow oxygen as the sole method of gas exchange during anastomosis construction. Read More

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Management of Life-Threatening Asthma: Severe Asthma Series.

Chest 2022 Feb 23. Epub 2022 Feb 23.

Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX.

Asthma exacerbations can be life-threatening, with 25,000 to 50,000 such patients per year requiring admission to an ICU in the United States. Appropriate triage of life-threatening asthma is dependent on both static assessment of airway function and dynamic assessment of response to therapy. Treatment strategies focus on achieving effective bronchodilation with inhaled β-agonists, muscarinic antagonists, and magnesium sulphate while reducing inflammation with systemic corticosteroids. Read More

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February 2022

High-flow nasal oxygen as first-line therapy for COVID-19-associated hypoxemic respiratory failure: a single-centre historical cohort study.

Can J Anaesth 2022 05 24;69(5):582-590. Epub 2022 Feb 24.

Division of Critical Care, Jewish General Hospital, McGill University, Pavilion H-364.1, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada.

Purpose: The optimal noninvasive modality for oxygenation support in COVID-19-associated hypoxemic respiratory failure and its association with healthcare worker infection remain uncertain. We report here our experience using high-flow nasal oxygen (HFNO) as the primary support mode for patients with COVID-19 in our institution.

Methods: We conducted a single-centre historical cohort study of all COVID-19 patients treated with HFNO for at least two hours in our university-affiliated and intensivist-staffed intensive care unit (Jewish General Hospital, Montreal, QC, Canada) between 27 August 2020 and 30 April 2021. Read More

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Usage of high-flow oxygen therapy outside the intensive care unit: a possibility to delay or prevent the need for mechanical ventilation among COVID-19 patients

Orv Hetil 2022 02 13;163(7):254-266. Epub 2022 Feb 13.

3 Somogy Megyei Kaposi Mór Oktató Kórház, Aneszteziológiai és Intenzív Terápiás Osztály Kaposvár Magyarország.

Összefoglaló. Bevezetés és célkitűzés: Szakirodalmi adatok a súlyos lefolyású COVID-19 terápiájában a noninvazív megoldások előnyét jelezték a prompt invazív megoldásokhoz képest. A COVID-19-pandémia drámai helyzetében felmerült a nagy áramlású oxigénnel (HFO) végzett terápia alkalmazásának létjogosultsága az intenzív terápiás osztály (ITO) keretein kívül. Read More

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February 2022

A Case of Complicated Traumatic Generalized Surgical Emphysema, Pneumomediastinum, Pneumopericardium, Pneumothorax, and Pneumoperitoneum Due to Accidental Dislodgement of Tracheostomy Tube.

Cureus 2021 Dec 27;13(12):e20762. Epub 2021 Dec 27.

Cardiology, Al Jufairi Diagnostic and Therapeutic Hospital, Doha, QAT.

A tracheostomy tube (TT) is usually taken out in a well-planned and coordinated manner after the underlying condition that necessitated the procedure is resolved. The inadvertent removal or dislodgement of the TT from the stroma is known as accidental extubation or decannulation. This event may prove fatal in a stable patient. Read More

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December 2021

Barotrauma and COVID-19.

Ken Hillman

Intensive Care Med 2022 03 28;48(3):376. Epub 2022 Jan 28.

The Simpson Centre for Health Services Research, University of New South Wales, Ingham Institute for Applied Medical Research, Sydney, Australia.

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Negative pressure therapy as a safe alternative in the treatment of massive subcutaneous emphysema in critically ill patients COVID-19.

Heart Lung 2022 Mar-Apr;52:190-193. Epub 2022 Jan 13.

Department of General Surgery, Colorectal Unit, Elche University Hospital, Alicante, Spain; Department of Pathology and Surgery of University Miguel Hernández of Elche, Alicante, Spain.

Many surgical treatments have been described for massive subcutaneous emphysema (MSE) over the recent years. However, there is no consensus on which is the most recommended and there is great diversity in treatment. With new advances in minimally invasive therapy performed at the bedside, especially in intensive care units, it has been possible to increase therapeutic efficacy. Read More

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Evidence-Based Mechanical Ventilatory Strategies in ARDS.

J Clin Med 2022 Jan 10;11(2). Epub 2022 Jan 10.

Southeast Health, Dothan, AL 36301, USA.

Acute respiratory distress syndrome (ARDS) remains one of the leading causes of morbidity and mortality in critically ill patients despite advancements in the field. Mechanical ventilatory strategies are a vital component of ARDS management to prevent secondary lung injury and improve patient outcomes. Multiple strategies including utilization of low tidal volumes, targeting low plateau pressures to minimize barotrauma, using low FiO (fraction of inspired oxygen) to prevent injury related to oxygen free radicals, optimization of positive end expiratory pressure (PEEP) to maintain or improve lung recruitment, and utilization of prone ventilation have been shown to decrease morbidity and mortality. Read More

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January 2022

Pulmonary barotrauma in patient suffering from COVID-19.

Heliyon 2022 Jan 10;8(1):e08745. Epub 2022 Jan 10.

Section of Diagnostic and Interventional Radiology, Department of Biomedical Sciences and Morphological and Functional Imaging, "G. Martino" University Hospital Messina, Messina, Italy.

Pneumothorax and pneumomediastinum are life-threatening conditions especially in critically ill patients. One of the most common situations in which they occur is prolonged invasive and non-invasive mechanical ventilation with high end-expiratory pressure. Probably due to the high number of patients with SARS-CoV-2 respiratory infection being treated with mechanical ventilation, increasing number of pulmonary barotrauma cases have been reported. Read More

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January 2022

Pneumothorax and pneumomediastinum in patients with COVID-19: A retrospective study from tertiary care institute in India.

Drug Discov Ther 2021 ;15(6):310-316

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

COVID-19 is associated with rarer extra-parenchymal manifestations, namely pneumothorax (PTX) and pneumomediastinum (PM) leading to complications and increased mortality. The study aims to describe the prevalence, risk factors for mortality, radiological characteristics and outcome of PTX/PM in patients admitted with COVID-19. This was a retrospective, single-centre, observational study in patients with confirmed COVID-19 presenting with non-iatrogenic PTX/PM from April 2020 to May 2021. Read More

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January 2022

Pulmonary barotrauma in COVID-19: A systematic review and meta-analysis.

Ann Med Surg (Lond) 2022 Jan 3;73:103221. Epub 2022 Jan 3.

Department of Radiology, Division of Thoracic Imaging, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA.

Background: An ever-increasing number of studies have reported an increased incidence of spontaneous pulmonary barotrauma such as pneumothorax, pneumomediastinum, and subcutaneous emphysema in patients with COVID-19. We conducted this systematic review and meta-analysis to assess the value and significance of the available data.

Methods: A thorough systematic search was conducted to identify studies of barotrauma in hospitalized patients with COVID-19. Read More

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January 2022