Occurrence, Risk Factors, and Outcomes of Pulmonary Barotrauma in Critically Ill COVID-19 Patients: A Retrospective Cohort Study
Table 5
Characteristics of the 49 patients with pulmonary barotrauma who survived to hospital discharge and died in the hospital.
Variable
Survived N = 15
Died N = 34
value
Age (years), mean ± SD
60.7 ± 16.2
64.8 ± 12.6
0.337
Sex, N (%)
Males
13 (86.7)
24 (70.6)
0.298
Females
2 (13.3)
10 (29.4)
Body mass index (kg/m2), median (Q1, Q3)
25.9 (24.5, 30.9)
32.7 (28.0, 37.5)
0.005
Comorbidities
Obesity, N (%)
2 (13.3)
4 (11.8)
1.0
Hypertension, N (%)
12 (80.0)
23 (67.6)
0.502
Diabetes, N (%)
14 (93.3)
31 (91.2)
1.0
Chronic kidney disease, N (%)
1 (6.7)
4 (11.8)
1.0
Hyperlipidemia, N (%)
5 (33.3)
8 (23.5)
0.500
Chronic obstructive pulmonary disease, N (%)
0 (0)
1 (2.9)
1.0
Asthma, N (%)
5 (33.3)
3 (8.8)
0.047
Previous pneumothorax, N (%)
0 (0.0)
0 (0.0)
—
Interstitial lung disease, N (%)
1 (6.7)
0 (0)
0.306
Stroke, N (%)
1 (6.7)
1 (2.9)
0.523
Heart failure, N (%)
3 (20.0)
1 (2.9)
0.079
Non-alcoholic fatty liver disease, N (%)
0 (0.0)
0 (0.0)
—
Arthritis, N (%)
0 (0.0)
5 (14.7
0.306
Cancer, N (%)
0 (0.0)
0 (0.0)
—
Depression, N (%)
1 (2.0)
1 (2.9)
1.0
Laboratory findings
White blood cell count (×109/L) mean ± SD
11.6 ± 5.0
10.7 ± 4.8
0.520
Neutrophil count (×109/L) mean ± SD
9.4 ± 3.3
8.2 ± 3.3
0.341
Lymphocyte count (×109/L), median (Q1, Q3)
0.6 (0.6, 0.7)
0.9 (0.7, 1.1)
0.025
Hemoglobin (g/L) mean ± SD
134.5 ± 21.4
135.0 ± 30.6
0.949
Platelets (×109/L) mean ± SD
246.1 ± 97.4
255.8 ± 113.8
0.776
Creatinine (μmol/L), median (Q1, Q3)
81.0 (67.0, 111.0)
91.0 (68.0, 123.0)
0.632
Lactate (mmol/L) median (Q1, Q3)
1.9 (1.6, 2.6)
1.9 (1.3, 2.6)
0.921
Fibrinogen (g/L) mean ± SD
4.35 ± 1.76
5.63 ± 2.00
0.247
D-dimer (μg/mL) median (Q1, Q3)
3.63 (1.14, 4.64)
1.90 (0.76, 6.35)
0.556
Ferritin (μg/L) median (Q1, Q3)
894.0 (497.7, 3792.61)
673.0 (370.4, 1362.4)
0.296
Management of COVID-19
Systemic corticosteroids, N (%)
12 (80.0)
31 (91.2)
0.353
High flow nasal oxygen, N (%)
12 (80.0)
17 (50.0)
0.049
Non-invasive ventilation, N (%)
9 (60.0)
25 (73.5)
0.502
Intubation/invasive ventilation, N (%)
10 (66.7)
33 (97.1)
0.008
Ventilator settings (day 1)
Lowest FiO2, mean ± SD
35.8 ± 10.1
47.5 ± 15.4
0.031
Maximum PEEP (cmH2O), mean ± SD
10.8 ± 2.3
11.8 ± 2.2
0.214
Maximum tidal volume (ml), mean ± SD
405.0 ± 44.8
407.6 ± 50.8
0.886
Tidal volume (ml) per kg ideal body weight, median (Q1, Q3)
6.5 (6.0, 6.9)
7.0 (6.0, 7.6)
0.358
Maximum peak airway pressure (cm H2O) mean ± SD
30.8 ± 4.0
31.8 ± 5.2
0.612
Maximum plateau pressure (cm H2O), mean ± SD
24.7 ± 5.9
27.8 ± 5.0
0.341
Type of barotrauma, N (%)
Pneumothorax
10 (66.7)
11 (32.4)
0.025
Pneumomediastinum
9 (60.0)
16 (47.1)
0.404
Subcutaneous emphysema
10 (66.7)
15 (44.1)
0.146
PEEP: positive end-expiratory pressure, SD: standard deviation, IJ: internal jugular, FiO2: fraction of inspired oxygen, Q1: first quartile, and Q3: third quartile.
