The incidence and risk factors for barotrauma in COVID-19 in intensive care unit, a single-center retrospective study

Background and Objectives: Coronavirus disease-19 (COVID-19) led to respiratory failure and is sometimes complicated with barotrauma. The knowledge about risk factors for the development of barotrauma is scarce and conflict. We aimed to examine the incidence and risk factors for the development of barotrauma in COVID-19 patients who followed up in the intensive care unit (ICU). Materials and Methods: Patients who admitted to ICU from March 15, 2020, to March 31, 2022 were included in the study and retrospectively screened for barotrauma. Patients with barotrauma at ICU admission were excluded from the study. A multiple regression analysis was performed to determine the risk factors for the development of barotrauma. Results: A total of 1113 patients were included in the study, 676 (60.7%) of them were COVID-19. During the study period, at least one barotrauma event was observed in 96 (8.6%) patients. Barotrauma was more common in patients with COVID-19 than non-COVID-19 patients (10.9% vs. 5%, P = 0.001). Positive pressure ventilation was found as the strongest independent risk factor for the development of barotrauma (odds ratio [OR] = 8.80, confidence intervals [CI], 3.88–19.98, P < 0.001). Steroid use also increased the development of barotrauma (OR = 3.45, CI, 1.78–6.67, P = 0.005). Patients with barotrauma had longer length of ICU stay and higher mortality rate than patients without barotrauma. Conclusion: Patients with COVID-19 have a higher risk for the development of barotrauma. Barotrauma is associated with longer ICU stay and increased mortality. Positive pressure ventilation and steroid use are the independent risk factors for barotrauma.