COVID-19 重症患者气胸发生率和死亡率高。
High incidence and mortality of pneumothorax in critically Ill patients with COVID-19.
机构信息
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuzhong District, Chongqing 400016, China.
Department of Respiratory and Critical Care Medicine, Chongqing Three Gorges Central Hospital, Chongqing, China.
出版信息
Heart Lung. 2021 Jan-Feb;50(1):37-43. doi: 10.1016/j.hrtlng.2020.10.002. Epub 2020 Oct 14.
BACKGROUND
The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified.
OBJECTIVES
To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19.
METHODS
Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax.
RESULTS
The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% (5/21) in patients receiving mechanical ventilation, and 56% (5/9) in patients requiring invasive mechanical ventilation, with 80% (4/5) patients died. All the 5 patients were male and aged ranging from 54 to 79 years old. Pneumothorax was most likely to occur 2 weeks after the beginning of dyspnea and associated with reduction of neuromuscular blockers, recruitment maneuver, severe cough, changes of lung structure and function.
CONCLUSIONS
Pneumothorax is a frequent and fatal complication of critically ill patients with COVID-19.
背景
COVID-19 合并气胸患者的临床特征尚不清楚。
目的
确定 COVID-19 危重症患者气胸的流行病学和发病风险。
方法
回顾性收集和分析 5 例气胸患者的病历、实验室检查、胸部 X 线和 CT 图像。
结果
ARDS 患者气胸发生率为 10%（5/49），机械通气患者为 24%（5/21），有创机械通气患者为 56%（5/9），病死率为 80%（4/5）。所有 5 例患者均为男性，年龄 54~79 岁。气胸最常发生在呼吸困难开始后 2 周，与神经肌肉阻滞剂减少、复张手法、剧烈咳嗽、肺结构和功能改变有关。
结论
气胸是 COVID-19 危重症患者的一种常见且致命的并发症。
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