Pneumothorax in patients with respiratory failure in ICU

Thachuthara-George, Joseph

doi:10.21037/jtd-19-3752

Cited by 13 publications

(28 citation statements)

References 62 publications

(71 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The total percentage of IMV-related air leakages in the study hospital in the past 5 years was 7.5%, which is consistent with the literature. In addition, this study concluded that air leakages increased the length of hospitalization stay and the duration of mechanical ventilation in patients, in agreement with previous reports of adult patients [ 15 , 16 ].…”

Section: Discussionsupporting

confidence: 92%

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Yin

Yang

et al. 2022

Eur J Med Res

View full text Add to dashboard Cite

Purpose This study aimed to investigate air leakage during invasive mechanical ventilation (IMV) in a pediatric intensive care unit (PICU) and explore potential risk factors. Methods We conducted a retrospective cohort study of children who underwent IMV in a single-center PICU in a tertiary referral hospital. Air leakage risk factors and factors associated with an improved outcome were assessed. Results A total of 548 children who underwent IMV were enrolled in this study. Air leakage occurred in 7.5% (41/548) of the cases in the PICU. Air leakage increased the duration of IMV and hospitalization time. Multivariate logistic regression analysis showed a higher risk of air leakage during IMV for PICU patients with acute respiratory dyspnea syndrome (ARDS) (OR = 4.38), a higher pediatric critical illness score (PCIS) (OR = 1.08), or a higher peak inspiratory pressure (PIP) (OR = 1.08), whereas the risk was lower for patients with central respiratory failure (OR = 0.14). The logistic model had excellent predictive power for air leakage, with an area under the curve of 0.883 and tenfold cross-validation. Patients aged between 1 and 6 years who were diagnosed with measles or pneumonia and had a low positive end-expiratory pressure (PEEP) or high PaO2/FiO2 ratio were associated with improved outcomes. Patients diagnosed with central respiratory failure or congenital heart diseases were associated with less desirable outcomes. Conclusions Patients with ARDS, a higher PCIS at admission or a higher PIP were at higher risk of air leakage.

show abstract

Section: Discussionsupporting

confidence: 92%

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Yin

Yang

et al. 2022

Eur J Med Res

View full text Add to dashboard Cite

show abstract

“…Before putting the patient on a mechanical ventilator, we should rule out pneumothorax, as mechanical ventilation can exacerbate pneumothorax. Our patient on admission had bilaterally diminished breath sounds and a hyper-resonant note suggesting he had bilateral pneumothorax prior to mechanical ventilation [7].…”

Section: Role Of the Ventilator In Pneumothoraxmentioning

confidence: 65%

Timely Management of Simultaneous Bilateral Spontaneous Pneumothorax: A Near-Death Experience

Gaidhane¹,

Batra²,

Nirmal³

et al. 2023

Cureus

View full text Add to dashboard Cite

Simultaneous bilateral spontaneous pneumothorax is a situation that rarely occurs. The patient can have various presentations, from dyspnoea and chest pain to significant respiratory failure. Although it causes lung collapse in nearly two thirds of cases, early diagnosis and treatment are of the utmost importance. Here, we present the case of an 18-year-old boy who presented with complaints of sudden onset respiratory distress. He was immediately put on mechanical ventilation. He was diagnosed with simultaneous bilateral spontaneous pneumothorax on chest X-ray. He needed bilateral intra-thoracic drainage, following which a video-assisted thoracoscopy was done on the left side.

show abstract

“…Patients with particularly complex prolonged ICU courses were also at increased risk for longterm ventilation, indicative of the use of Extracorporeal lung assist (ECLA) or extracorporeal membrane oxygenation (ECMO), positioning therapy, transfusion of plasma components or coagulation factors. The use of a chest tube as a further risk factor indicates either a pre-existing pulmonary condition or complications related to barotrauma or iatrogenesis [23]. In addition, procedures suggestive of leading neurological problems such as cerebral spinal surgeries, cerebrospinal uid system surgeries, or cranial imaging were also predictors for unfavourable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for long-term invasive mechanical ventilation:a retrospective longitudinal study using German health claims data

Trudzinski

Michels

Neetz

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose Long-term invasive mechanical ventilation (IMV) is a major burden for those affected and causes high costs for the health care system. Early risk assessment is a prerequisite for the best possible support of high-risk patients during the weaning process. We aimed to identify risk factors for long-term IMV within 96 hours after the onset of IMV. Methods The analysis was based on data from the AOK Baden-Württemberg; patients who received IMV ≥ 96h and were discharged between 2015 and 2017 were analysed. Health claims data were considered for the previous year and 30 days after hospitalisation. Long-term IMV was defined as evidence of invasive home mechanical ventilation (HMV), IMV≥ 500h, or readmission with (re)prolonged ventilation. The performance of the model was evaluated on a 2018 data-set. Results 7.584 hospitalisations were analysed. Criteria for long-term IMV were met in 38.3% of cases, of which 13.9% had evidence of HMV, 73.1% were ventilated >500 hours and/or 40.3% were rehospitalised with IMV. Several risk factors could be identified, including pre-existing conditions, admission diagnosis, prescribed aids and procedures. By combining all these factors into a final model, the risk for long-term IMV could be estimated with a sensitivity and specificity of respectively 49 and 80% on the test data set (when classifiying patients based on their predicted probability with a cut-off of 41.15%). Conclusion Based on health claims data alone, the risk for long-term IMV could be estimated with an acceptable predictive quality as early as 96 hours after the start of IMV.

show abstract

Pneumothorax in patients with respiratory failure in ICU

Cited by 13 publications

References 62 publications

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units

Timely Management of Simultaneous Bilateral Spontaneous Pneumothorax: A Near-Death Experience

Risk factors for long-term invasive mechanical ventilation:a retrospective longitudinal study using German health claims data

Contact Info

Product

Resources

About