ArticlePulmonology
Ventilatory associated barotrauma in COVID-19 patients: A multicenter observational case control study (COVI-MIX-study).
Registry-linked trialOpen access · diamondAbstract readMulticenter Study
In one paragraph
Article in Pulmonology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04897152 (Coronavirus Associated Pneumomediastinum and Pneumothorax - COVIMIX Study), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
6.5field-weighted citation impact, top 2% of its field
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Coronavirus Associated Pneumomediastinum and Pneumothorax - COVIMIX Study
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
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- High-flow nasal cannula oxygen reduced hypoxemia in patients undergoing gastroscopy under general anesthesia at ultra-high altitude: a randomized controlled trial.BMC anesthesiology · 2024Trial
- Determinants of Postoperative Pulmonary Complications and Optimization Strategies for Intraoperative Respiratory Management After Laparoscopic Gastrointestinal Cancer Surgery.Annals of surgical oncology · 2026Article
- High-flow nasal therapy vs conventional oxygen therapy in mild COVID-19 hypoxaemia: a Bayesian reanalysis of the COVID-HIGH Trial.Journal of anesthesia, analgesia and critical care · 2026Article
- Application of neurally adjusted ventilatory assist (NAVA): a narrative review.Journal of thoracic disease · 2025Review
- Ventilatory response and delirium risk in hospitalised patients with acute hypoxia due to COVID-19.Scientific reports · 2025Article
- Contribution of lung ultrasound to assess COVID-19 pneumonia in critical care setting: a prospective cohort study.Scientific reports · 2025Article
- Comorbidities and Severe COVID-19 Outcomes: A Retrospective Analysis of Hospitalized Patients in Three Counties in Romania.Microorganisms · 2025Article
- Lessons Learned From Awake ECMO Approach in Covid-19-Related Acute Respiratory Distress Syndrome - a Scoping Review.Therapeutics and clinical risk management · 2025Review
- The Role of Medical Thoracoscopy with Talc Poudrage in Spontaneous, Iatrogenic, and Traumatic Pneumothorax: A Prolonged Experience of a Tertiary Care Center.Pulmonary therapy · 2024Article
- Effect on post-operative pulmonary complications frequency of high flow nasal oxygen versus standard oxygen therapy in patients undergoing esophagectomy for cancer: study protocol for a randomized controlled trial-OSSIGENA study.Journal of thoracic disease · 2024Article
- Handgrip strength as a prognostic factor for COVID-19 mortality among older adult patients admitted to the intensive care unit (ICU): a comparison Alpha (B.1.1.7) and Delta (B.1.617.2) variants.Scientific reports · 2024Article
- Predictive value of inflammatory factors and lymphocyte counts in tracheal intubation and death after infection with COVID-19.BMC pulmonary medicine · 2024Article
- Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2024Article
- Comparison between high-flow nasal oxygen (HFNO) alternated with non-invasive ventilation (NIV) and HFNO and NIV alone in patients with COVID-19: a retrospective cohort study.European journal of medical research · 2024Article
- Beyond diagnosis: a narrative review of the evolving therapeutic role of medical thoracoscopy in the management of pleural diseases.Journal of thoracic disease · 2024Review
- Investigation of Serum Endocan Levels in SARS-CoV-2 Patients.International journal of molecular sciences · 2024Article
- Article
- Noninvasive respiratory support in the perioperative setting: a narrative review.Frontiers in medicine · 2024Review
Corrections and comments
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Authors and funding
72 authors at 20 institutions in 10 countries.
Luigi VetrugnoDepartment of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. Electronic address: luigi.vetrugno@unich.it.
Nadia CastaldoPulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Alberto FantinPulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Cristian DeanaDepartment of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Andrea CortegianiDepartment of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy; Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.
Federico LonghiniDepartment of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Francesco ForforiDepartment of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, AOUP-Pisa, Italy.
Gianmaria CammarotaAnesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy.
Domenico Luca GriecoDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy; Department of Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Miriam IsolaDepartment of Medicine, University of Udine, Udine, Italy.
Paolo NavalesiInstitute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy; Department of Medicine (DIMED), University of Padua, Padua, Italy.
Salvatore Maurizio MaggioreDepartment of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, Chieti, Italy.
Matteo BassettiInfectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
Alfredo ChettaRespiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Marco ConfalonieriDepartment of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy.
Maria De MartinoDepartment of Medicine, University of Udine, Udine, Italy.
Giovanni FerrariPneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy.
Daniela FrancisiDepartment of Infectious Disease "S. Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
Roberto LuzzatiInfectious Disease Unit, University of Trieste, Trieste, Italy.
Simone MeiniU.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy.
Mariano ScozzafavaRespiratory High Dependecy Unit - General Hospital Lodi, Lodi, Italy.
Emanuela SozioInfectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Carlo TasciniDepartment of Medicine, University of Udine, Udine, Italy; Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Flavio BassiDepartment of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Vincenzo PatrunoPulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Italian COVI-MIX Study GroupDepartment of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy.
Edoardo De RobertisAnesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy.
Chiara AldieriDivision of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy.
Lorenzo BallAnesthesia and Intensive Care, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Elisa BaratellaDepartment of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy.
Michele BartolettiInfectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy.
Annalisa BoscoloInstitute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy.
Barbara BurgazziRespiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Vito CatalanottiInfectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy.
Paola ConfalonieriDepartment of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy.
Silvia CorcioneDepartment of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy.
Francesco Giuseppe De RosaInfectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy; Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy.
Alessandro De SimoniRespiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Valerio Del BonoDivision of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy.
Roberta Di TriaPneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy.
Sara ForlaniPulmonary Medicine Unit, Lodi General Hospital, Lodi, Italy.
Daniele Roberto GiacobbeInfectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
Bianca GranozziInfectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy.
Laura LabateInfectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
Sara LococoDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Tommaso LupiaInfectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy.
Carola MatellonDepartment of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Sara MehrabiInfectious Diseases Division, Diagnostics and Public Health Department, University of Verona, Verona, Italy.
Sabrina MorosiDepartment of Infectious Disease "S. Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
Silvia MongodiAnaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Maddalena MuraU.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy.
Stefano NavaDepartment of Clinical, Integrated and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy; Respiratory and Critical Care Unit, Sant Orsola University Hospital, Bologna, Italy.
Riccardo PolInfectious Disease Unit, University of Trieste, Trieste, Italy.
Tommaso PettenuzzoInstitute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy.
Nguyen Hoang QuyenDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Carolina RescignoUOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. "D. Cotugno", Naples, Italy.
Elda RighiDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Barbara RuaroDepartment of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy.
Francesco SaltonDepartment of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy.
Silvia ScabiniDepartment of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy.
Angelo ScardaRespiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy.
Marcella SibaniDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Evelina TacconelliDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Gennaro TartaglioneRespiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy.
Beatrice TazzaInfectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy.
Eleonora VaniaInfectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy.
Pierluigi VialeInfectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy.
Andrea VianelloDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Alessandro VisentinDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Umberto ZucconRespiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy.
Francesco MeroiDepartment of Medicine, University of Udine, Udine, Italy.
Danilo BuonsensoDepartment of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
University of Padua · ITUniversity of Trieste · ITUniversity of Verona · ITUniversity of Parma · ITAzienda Ospedaliera Santa Maria Degli Angeli · ITUnited States Agency for International Development · USUniversity of Perugia · ITUniversity of Udine · ITIRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola · ITNara University · JPOspedale Policlinico San Martino · ITUniversity of Pisa · ITAgency for Integrated Care · SGAzienda Sanitaria Locale di Asti · ITUniversity of Chieti-Pescara · ITAgostino Gemelli University Polyclinic · ITAzienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo · ITAzienda Sanitaria Ospedaliera S.Croce e Carle Cuneo · ITCardinal Health (Australia) · AUMagna Graecia University · IT
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of barotrauma associated with different types of ventilatory support is unclear in COVID-19 patients. The primary aim of this study was to evaluate the effect of the different respiratory support strategies on barotrauma occurrence; we also sought to determine the frequency of barotrauma and the clinical characteristics of the patients who experienced this complication.
methodsThis multicentre retrospective case-control study from 1 March 2020 to 28 February 2021 included COVID-19 patients who experienced barotrauma during hospital stay. They were matched with controls in a 1:1 ratio for the same admission period in the same ward of treatment. Univariable and multivariable logistic regression (OR) were performed to explore which factors were associated with barotrauma and in-hospital death.
resultsWe included 200 cases and 200 controls. Invasive mechanical ventilation was used in 39.3% of patients in the barotrauma group, and in 20.1% of controls (p<0.001). Receiving non-invasive ventilation (C-PAP/PSV) instead of conventional oxygen therapy (COT) increased the risk of barotrauma (OR 5.04, 95% CI 2.30 - 11.08, p<0.001), similarly for invasive mechanical ventilation (OR 6.24, 95% CI 2.86-13.60, p<0.001). High Flow Nasal Oxygen (HFNO), compared with COT, did not significantly increase the risk of barotrauma. Barotrauma frequency occurred in 1.00% [95% CI 0.88-1.16] of patients; these were older (p=0.022) and more frequently immunosuppressed (p=0.013). Barotrauma was shown to be an independent risk for death (OR 5.32, 95% CI 2.82-10.03, p<0.001).
conclusionsC-PAP/PSV compared with COT or HFNO increased the risk of barotrauma; otherwise HFNO did not. Barotrauma was recorded in 1.00% of patients, affecting mainly patients with more severe COVID-19 disease. Barotrauma was independently associated with mortality.
trial registrationthis case-control study was prospectively registered in clinicaltrial.gov as NCT04897152 (on 21 May 2021).
Indexed as
BarotraumaCOVID-19Case-Control StudiesHospital MortalityHumansOxygenRetrospective StudiesOxygenAcute respiratory failureBarotraumaCOVID-19High flow nasal cannulaInvasive mechanical ventilationPneumothorax
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Registered trials
NCT04897152ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.