Goossen Robin L, Verboom Mariëlle, Blacha Mariëlle, Smesseim Illaa, Beenen Ludo F M, Meenen David M P van, Paulus Frederique, Schultz Marcus J
Department of Intensive Care, Amsterdam University Medical Centers, Location 'AMC', 1105 AZ Amsterdam, The Netherlands.
Department of Thoracic Oncology, Antoni van Leeuwenhoek Ziekenhuis, 1066 CX Amsterdam, The Netherlands.
Diagnostics (Basel). 2023 Mar 17;13(6):1156. doi: 10.3390/diagnostics13061156.
Subcutaneous emphysema, pneumothorax and pneumomediastinum are well-known complications of invasive ventilation in patients with acute hypoxemic respiratory failure. We determined the incidences of air leaks that were visible on available chest images in a cohort of critically ill patients with acute hypoxemic respiratory failure due to coronavirus disease of 2019 (COVID-19) in a single-center cohort in the Netherlands. A total of 712 chest images from 154 patients were re-evaluated by a multidisciplinary team of independent assessors; there was a median of three (2-5) chest radiographs and a median of one (1-2) chest CT scans per patient. The incidences of subcutaneous emphysema, pneumothoraxes and pneumomediastinum present in 13 patients (8.4%) were 4.5%, 4.5%, and 3.9%. The median first day of the presence of an air leak was 18 (2-21) days after arrival in the ICU and 18 (9-22)days after the start of invasive ventilation. We conclude that the incidence of air leaks was high in this cohort of COVID-19 patients, but it was fairly comparable with what was previously reported in patients with acute hypoxemic respiratory failure in the pre-COVID-19 era.
皮下气肿、气胸和纵隔气肿是急性低氧性呼吸衰竭患者有创通气的常见并发症。我们在荷兰的一个单中心队列中，确定了一组因2019冠状病毒病（COVID-19）导致急性低氧性呼吸衰竭的重症患者中，在可用胸部影像上可见的空气泄漏发生率。一个多学科独立评估团队对154例患者的712张胸部影像进行了重新评估；每位患者胸部X线片的中位数为3张（2 - 5张），胸部CT扫描的中位数为1张（1 - 2张）。13例患者（8.4%）出现皮下气肿、气胸和纵隔气肿，发生率分别为4.5%、4.5%和3.9%。空气泄漏出现的中位首日为入住重症监护病房后18天（2 - 21天），有创通气开始后18天（9 - 22天）。我们得出结论，在这组COVID - 19患者中空气泄漏的发生率较高，但与COVID - 19大流行前时代急性低氧性呼吸衰竭患者先前报告的发生率相当。
