![]() To identify potential barotrauma events in the historical ARDS cohort, we performed a word search in the electronic medical record system for the same terms. Patients identified as having procedure-related pneumothoraces based on clinical assessment by intensivists were excluded. To identify potential barotrauma events (the generation of air outside of the pleural surfaces of the lungs caused by increased pressure within distal airways and alveoli) in the contemporaneous COVID-19 positive and negative cohorts, we performed a word search of imaging reports within our Radiology Information System (Primordial Nuance Communication, Burlington, Mass) with any of the following terms: pneumothorax, pneumomediastinum, mediastinal air, pneumopericardium, subcutaneous emphysema, and the appropriate plural of each term. All patients from February 1, 2016, through February 1, 2020, who were diagnosed with ARDS and required IMV during their hospitalization were included. To identify a historical comparator group of patients with ARDS before the COVID-19 pandemic, we used a search tool embedded in the electronic medical record system (Slicer Dicer Epic Systems). Department of Health and Human Services guidelines directing the frequency and timing of COVID-19 testing for defined inpatient populations, based on the pretest probability of COVID-19. Centers for Disease Control and Prevention and U.S. ![]() The institutional infection prevention and control policy during this period for COVID-19 testing followed U.S. If patients had a positive SARS-CoV2 reverse transcription polymerase chain reaction test result during their hospital stay, they were included in the COVID-19 positive cohort. Inclusion in the study was further limited to patients admitted to our hospitals who required IMV. COVID-19 testing was performed in all patients who presented to the emergency department in this time period, regardless of symptoms and radiographic findings. Patients with positive real-time reverse transcription polymerase chain reaction assays were deemed COVID-19 positive, and those with negative results were deemed COVID-19 negative. Test assay techniques are detailed in Appendix E1 (online). The New York University Langone Health electronic medical record system (Epic Systems, Verona, Wis) was searched for patients age 18 years or older seen in our emergency department between March 1, 2020, and April 6, 2020, with chest imaging within 24 hours of nasopharyngeal or oropharyngeal swab testing for SARS-CoV-2. 03) and is associated with a longer hospital stay (odds ratio = 0.92 P <. Barotrauma is an independent risk factor for death in COVID-19 (odds ratio = 2.2 P =. 001 vs the group with COVID-19 infection). Of 285 patients with acute respiratory distress syndrome on invasive mechanical ventilation during the previous 4 years (mean age, 68 years ± 17 60% men), 28 patients (10%) had 31 barotrauma events, with an overall barotrauma rate of 11% (95% CI: 8%, 15% P <. ![]() ![]() ![]() During the same period, 196 patients without COVID-19 infection (mean age, 64 years ± 19 52% men) with invasive mechanical ventilation had one barotrauma event (0.5% 95% CI: 0%, 3% P <. Of the total, there were 89 (15%) patients with one or more barotrauma events for a total of 145 barotrauma events (24% overall events) (95% confidence interval : 21%, 28%). A total of 601 patients with COVID-19 infection underwent invasive mechanical ventilation (mean age, 63 years ± 15 71% men). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |