Khan Wajiha, Safi Adnan, Muneeb Muhammad, Mooghal Mehwish, Aftab Ali, Ahmed Jawad
Department of Medicine and Surgery, Dow University of Health and Sciences, Baba-e-Urdu Road, Karachi, 74200, Pakistan.
Department of Medicine and Surgery, Nishtar Medical University and Hospital, Nishtar Road, 60000, Multan, Pakistan.
Ann Med Surg (Lond). 2022 Aug;80:104201. doi: 10.1016/j.amsu.2022.104201. Epub 2022 Jul 16.
Critically ill COVID-19 patients have to undergo positive pressure ventilation, a non-physiological and invasive intervention that can be lifesaving in severe ARDS. Similar to any other intervention, it has its pros and cons. Despite following Lung Protective Ventilation (LPV), some of the complications are frequently reported in these critically ill patients and significantly impact overall mortality. The complications related to invasive mechanical ventilation (IMV) in critically ill COVID-19 patients can be broadly divided into pulmonary and non-pulmonary. Among pulmonary complications, the most frequent is ventilator-associated pneumonia. Others are barotrauma, including subcutaneous emphysema, pneumomediastinum, pneumothorax, bullous lesions, cardiopulmonary effects of right ventricular dysfunction, and pulmonary complications mimicking cardiac failure, including pulmonary edema. Tracheal complications, including full-thickness tracheal lesions (FTTLs) and tracheoesophageal fistulas (TEFs) are serious but rare complications. Non-Pulmonary complications include neurological, nephrological, ocular, and oral complications.
危重症新型冠状病毒肺炎患者必须接受正压通气，这是一种非生理性的侵入性干预措施，在严重急性呼吸窘迫综合征（ARDS）中可能挽救生命。与任何其他干预措施一样，它有其利弊。尽管遵循了肺保护性通气（LPV），但这些危重症患者中仍经常报告一些并发症，并且这些并发症会显著影响总体死亡率。危重症新型冠状病毒肺炎患者中与有创机械通气（IMV）相关的并发症可大致分为肺部并发症和非肺部并发症。在肺部并发症中，最常见的是呼吸机相关性肺炎。其他的是气压伤，包括皮下气肿、纵隔气肿、气胸、肺大疱病变、右心室功能障碍的心肺效应，以及类似心力衰竭的肺部并发症，包括肺水肿。气管并发症，包括全层气管病变（FTTLs）和气管食管瘘（TEFs）是严重但罕见的并发症。非肺部并发症包括神经、肾脏、眼部和口腔并发症。
