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Barotrauma and mechanical ventilation in critically ill patients COVID-19

Bolívar-Rodríguez, Martín Adrián1; Martínez-Nava, Juan Carlos1; Pamanes-Lozano, Adrián1; Cázarez-Aguilar, Marcel Antonio1; Quiroga-Arias, Víctor Elier1; Bolívar-Corona, Andrea1





2021, Number 1

2021; 80 (1)






ABSTRACT

Manifestations of SARS-CoV-2 pneumonia can rapidly progress to acute respiratory failure and acute respiratory distress syndrome that should receive timely ventilatory support invasive mechanical ventilation. Barotrauma is a complication that should be considered in this type of patient due to the risk of worsening the clinical course, increasing mortality risk. The mechanism of how barotrauma occurs in COVID-19 patient is related to lung damage associated with mechanical ventilation and structural changes caused by COVID-19 complications. Worldwide evidence on therapeutic management on barotrauma in COVID-19 patient is limited. Clinical evolution should be monitored due to the possibility of cardiovascular and respiratory complications, which must be resolved in a timely manner. The objective of this review is to inform about the current knowledge described in literature of this complication in COVID-19 patients, its incidence, pathophysiology, diagnosis, treatment and prognosis. Conclusions: Barotrauma presentation frequency increases in COVID-19 infected patients. Clinical manifestations can be nonspecific, so the diagnosis should have high suspicion. There is little evidence to date of pulmonary sequelae associated with barotrauma in these patients.

KEYWORDS

Barotrauma, invasive mechanical ventilation, pneumomediastinum, pneumothorax, COVID-19.

REFERENCES

  1. Abushahin A, Degliuomini J, Aronow WS, Newman TG. A case of spontaneous pneumothorax 21 days after diagnosis of coronavirus disease 2019 (COVID-19) pneumonia. Am J Case Rep. 2020;21:e925787. https://doi.org/10.12659/ajcr.925787

  2. Turchetto ES, Tusman G, Makinistian RL. Ventilación mecánica en la lesión pulmonar por SARS-CoV-2: ¿Qué puede aportar la capnografía volumétrica? Rev Esp Anestesiol Reanim. 2020. [Epub ahead of print]. Disponible en: https://dx.doi.org/10.1016%2Fj.redar.2020.05.008

  3. Suwanwongse K, Shabarek N. Pneumomediastinum in mechanically ventilated coronavirus disease 2019 patients. J Cardiothorac Vasc Anesth. 2020. [Epub ahead of print]. Available in: https://dx.doi.org/10.1053%2Fj.jvca.2020.06.058

  4. Quincho-López A, Quincho-López DL, Hurtado-Medina FD. Case report: pneumothorax and pneumomediastinum as uncommon complications of COVID-19 pneumonia-literature review. Am J Trop Med Hyg. 2020;103(3):1170-1176. https://doi.org/10.4269/ajtmh.20-0815

  5. Karnik AM. Management of pneumothorax and barotrauma: current concepts. Compr Ther. 2001;27(4):311-321. https://doi.org/10.1007/s12019-001-0029-x

  6. Díaz R, Heller D. Barotrauma and mechanical ventilation. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2020. Available in: https://www.ncbi.nlm.nih.gov/books/NBK545226/

  7. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324(8):782-793. https://doi.org/10.1001/jama.2020.12839

  8. Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med. 2013;369(22):2126-2136. https://doi.org/10.1056/nejmra1208707

  9. Pan C, Chen L, Lu C, Zhang W, Xia JA, Sklar MC, et al. Lung recruitability in COVID-19-associated acute respiratory distress syndrome: A single-center, observational study. Am J Respir Crit Care Med. 2020;201(10):1294-1297. https://doi.org/10.1164/rccm.202003-0527le

  10. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: overview and appearance on computed tomography. World J Radiol. 2014;6(11):850-854. https://doi.org/10.4329/wjr.v6.i11.850

  11. Grant MC, Geoghegan L, Arbyn M, Mohammed Z, McGuiness L, Clarke EL, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoS One. 2020;15(6):e0234765. https://doi.org/10.1371/journal.pone.0234765

  12. Álvarez CZ, Jadue AT, Rojas FR, Cerda CC, Ramírez MV, Cornejo CS. Neumomediastino espontáneo (síndrome de Hamman): Una enfermedad benigna mal diagnosticada. Rev Méd Chile. 2009;137(8):1045-1050.

  13. Brogna B, Bignardi E, Salvatore P, Alberigo M, Brogna C, Megliola A, et al. Unusual presentations of COVID-19 pneumonia on CT scans with spontaneous pneumomediastinum and loculated pneumothorax: A report of two cases and a review of the literature. Heart Lung. 2020 [Epub ahead of print]. Available in: https://dx.doi.org/10.1016%2Fj.hrtlng.2020.06.005

  14. Kouritas VK, Papagiannopoulos K, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Pneumomediastinum. J Thorac Dis. 2015;7(Suppl 1):S44-S49. https://doi.org/10.3978/j.issn.2072-1439.2015.01.11

  15. Anzueto A, Frutos-Vivar F, Esteban A, Alía I, Brochard L, Stewart T, et al. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intensive Care Med. 2004;30(4):612-619. https://doi.org/10.1007/s00134-004-2187-7

  16. McGuiness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM, et al. High incidence of barotrauma in patients with COVID-19 infection on invasive mechanical ventilation. Radiology. 2020 [Epub ahead of print]. Available in: https://doi.org/10.1148/radiol.2020202352

  17. Ioannidis G, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Lampakai S, et al. Barotrauma and pneumothorax. J Thorac Dis 2015;7(Suppl 1):S38-S43. https://doi.org/10.3978/j.issn.2072-1439.2015.01.31

  18. Martínez MS, Quintas RD, Velázquez PM. Tratamiento con drenajes subcutáneos en el neumomediastino y enfisema subcutáneo masivo (carta al editor). Arch Bronconeumol. 2013;49(3):127-128. doi: 10.1016/j.arbres.2012.09.001.

  19. Sherif HM, Ott DA. The use of subcutaneous drains to manage subcutaneous emphysema. Tex Heart Inst J. 1999;26(2):129-131.

  20. Abdallat M, Khalil M, Al-Awwa G, Kothuru R, Punzina CL. Barotrauma in COVID-19 Patients. J Lung Health Dis. 2020;4(2):8-12. https://www.researchgate.net/deref/http%3A%2F%2Fdx.doi.org%2F10.29245%2F2689-999X%2F2020%2F2.1163

  21. MacDuff A, Arnold A, Harvey J.; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65 Suppl 2):ii18-ii31. https://doi.org/10.1136/thx.2010.136986

  22. Hallifax R, Wrightson JM, Bibby A, Walker S, Stanton A, De Fonseca D, et al. Pleural services during the COVID-19 pandemic – revised. The British Thoracic Society. 2020. [Access date 2020 September 2] Available in: https://www.brit-thoracic.org.uk/document-library/quality-improvement/covid-19/Pleural-services-during-COVID-19-pandemic/

  23. Gorospe L, Ayala-Carbonero A, Ureña-Vacas A, Fra Fernández S, Muñoz-Molina GM, Arrieta P, et al. Spontaneous pneumomediastinum in patients with COVID-19: a case series of four patients. Arch Bronconeumol. 2020 [Epub ahead of print]. Available in: https://doi.org/10.1016/j.arbres.2020.06.008

  24. Plojoux J, Froudarakis M, Janssens JP, Soccal PM, Tschopp JM. New insights and improved strategies for the management of primary spontaneous pneumothorax. Clin Respir J. 2019;13(4):195-201. https://doi.org/10.1111/crj.12990

  25. Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P, et al. Coronavirus infections and immune responses. J Med Virol. 2020;92(4):424-432. https://doi.org/10.1002/jmv.25685

  26. Shekar K, Foot C, Fraser J, Ziegenfuss M, Hopkins P, Windsor M. Bronchopleural fistula: an update for intensivists. J Crit Care. 2010;25(1):47-55. https://doi.org/10.1016/j.jcrc.2009.05.007


2021, Number 1

2021; 80 (1)