Evaluation of Frequency and Risk Factors of Barotrauma among Patients with Severe Covid-19 Pneumonia Underwent Non-Invasive Ventilation in Afzalipour Hospital Kerman

Abstract

Acute respiratory distress syndrome (ARDS) following Covid-19 pneumo-nia is a common complication; using non-invasive ventilation (NIV) is one of the best options avai-lable. In the recent Covid-19 pandemic, we have seen a significant increase in barotrauma incidence following the use of NIV in patients with severe Covid-19 pneumonia. We aimed to identify the risk factors of barotrauma in patients with Covid-19 pneumonia under-going NIV. In this retrospective study, all adult patients with severe Covid-19 pneumonia who suffe-red from any form of barotrauma undergoing NIV from July to September 2021 in Afzalipour Hos-pital, Kerman, Iran were evaluated. Lab tests and NIV machine settings were collected from pa-tients' files. A chi-square test and an independent t-test were used for analytical statistics. Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestations of barotrauma were pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and lab tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04). According to the results of the study, using a low level of IPAP in the ventilator ma-chine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate, although its excessive reduction can cause pulmonary collapse and respiratory arrest as a result..