Male gender, age ≥61 years and diabetes mellitus were associated with PB in this observational study. PB events influence morbidity, length of ICU and hospital stay, and mortality. In this observational study of C-ARF patients, incidence of PB was at 2.35% with an incidence of PB events at 2.88%. The rest were managed conservatively and monitored with periodic imaging. The highest number of barotrauma events occurred on right side. Twelve spontaneously breathing patients developed PB. Pneumomediastinum was the most common barotrauma event followed by pneumothorax. Mean serum ferritin levels were higher in the males, 1601 ng/ml and the deceased 1794 ng/ml. No iatrogenic or traumatic barotrauma events were found. Only one patient had evidence of emphysematous changes in the lung on an HRCT chest. Twenty-three of invasively ventilated patients had proven evidence of secondary infection in the lungs during their hospital stay. Mean duration of development of barotrauma was in the second week in the non-ventilated group and after 2 weeks in the invasively ventilated group. These were documented as single event, multiple (>1 barotrauma), or separate (occurring sequentially at different points in time >72 h apart) barotrauma events.ĬOPD: chronic obstructive pulmonary disease APACHE II: acute physiology and chronic health evaluation, SOFA: sequential organ failure assessment, HFNO: high flow nasal oxygenĭiabetes was the most common (31.42%) comorbidity. Barotrauma was diagnosed on chest radiograph, high-resolution computerised tomography of chest (HRCT) or abdomen and included those with documented pneumothorax, pneumomediastinum, pneumopericardium or subcutaneous emphysema. Radiological images were reviewed by consensus by two trained radiologists. The recorded data included demographics (age, gender, comorbidities), severity scores (APACHE II on admission, SOFA on the day of barotrauma), maximum oxygen that patient was on (high flow nasal cannula, non-invasive ventilation, invasive ventilation), type of PB, worst ventilator parameters in invasively ventilated on the day of barotrauma (tidal volume, Positive end-expiratory pressure (PEEP)), day from hospital admission to barotrauma, occurrence of barotrauma (before or after invasive ventilation), need for tracheostomy, secondary infection in lung (bacterial, viral, fungal), laboratory parameters (d-dimer, serum ferritin), chest radiograph and HRCT chest finding, duration of hospital stay (days) and outcomes at hospital discharge (alive or deceased). Patient confidentiality was safeguarded by allocating a de-identified code. Data were entered into a predesigned online data acquisition system.
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