ArticleInteractive cardiovascular and thoracic surgery2022
Incidence and risk factors for pneumomediastinum in COVID-19 patients in the intensive care unit.
Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Effects of pulmonary air leak on patients with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- Pathological Presence of Free Air in the Thorax: Pneumothorax and Pneumomediastinum as a Complication of COVID-19.Cureus · 2023Article
- [COVID-19-associated lung weakness (CALW): Systematic review and meta-analysis].Medicina intensiva · 2023Article
- Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case-control study.BMC infectious diseases · 2023Article
- Should Pneumothorax Developing During the Recovery Period After COVID-19 in Patients with Previously Healthy Lungs be Considered a Primary Spontaneous Pneumothorax or a Secondary Spontaneous Pneumothorax?Turkish thoracic journal · 2022Article
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4 authors at 1 institution in 1 country.
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Abstract
objectivesThe incidence of pneumomediastinum (PNMD), its causes of development and its effect on prognosis in the coronavirus disease 2019 (COVID-19) are not clear.
methodsBetween March 2020 and December 2020, 427 patients with real-time reverse transcriptase-polymerase chain reaction-confirmed COVID-19 admitted to the intensive care unit were analysed retrospectively. Using receiver operating characteristic analysis, the area under the curve (AUC) for initial invasive mechanical ventilation (MV) variables such as initial peak inspiratory pressure (PIP), PaO2/FiO2 (P/F ratio), tidal volume, compliance and positive end-expiratory pressure was evaluated regarding PNMD development.
resultsThe incidence of PNMD was 5.6% (n = 24). PNMD development rate was 2.7% in non-invasive MV and 6.2% in MV [odds ratio (OR) 2.352, 95% confidence interval (CI) 0.541-10.232; P = 0.400]. In the multivariate analysis, the independent risk factors affecting the development of PNMD were PIP (OR 1.238, 95% CI 1.091-1.378; P < 0.001) and P/F ratio (OR 0.982, 95% CI 0.971-0.994; P = 0.004). P/F ratio (AUC 0.815, 95% CI 0.771-0.854), PIP (AUC 0.780, 95% CI 0.734-0.822), compliance (AUC 0.735, 95% CI 0.677-0.774) and positive end-expiratory pressure (AUC 0.718, 95% CI 0.668-0.764) were the best predictors for PNMD development. Regarding the multivariate analysis, independent risk factors affecting mortality were detected as age (OR 1.015, 95% CI 0.999-1.031; P = 0.04), comorbidity (OR 1.940, 95% CI 1.100-3.419; P = 0.02), mode of breathing (OR 48.345, 95% CI 14.666-159.360; P < 0.001), PNMD (OR 5.234, 95% CI 1.379-19.857; P = 0.01), positive end-expiratory pressure (OR 1.305, 95% CI 1.062-1.603; P = 0.01) and tidal volume (OR 0.995, 95% CI 0.992-0.998; P = 0.004).
conclusionsPNMD development was associated with the initial P/F ratio and PIP. Therefore, it was considered to be related to both the patient and barotrauma. PNMD is a poor prognostic factor for COVID-19.
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