Pnömotoraksın COVID-19 yoğun bakım hastalarında prognoz üzerine etkisi

Amaç: Bu çalışmada COVID-19 tanısı ile yoğun bakım ünitesinde takip edilen hastalarda pnömtoraksın prognoz ile ilişkisini incelemeyi amaçladık.Materyal ve Metot: Nisan 2020 ile Mart 2022 tarihleri arasında COVID-19 tanısı ile yoğun bakım ünitesi takibindeki hastaların dosyaları retrospektif olarak incelendi. Hastalar pnömotoraks gelişen ve gelişmeyenler şeklinde iki gruba ayrıldı. Elde edilen veriler her iki grup arasında kıyaslanarak pnömotoraksın prognoz ve mortalite üzerine etkisi tespit edilmeye çalışıldı.Bulgular: PNX (+) olan grupta MV ihtiyacı (p=0.049) ve MV süreleri (p=0.036) anlamlı olarak daha yüksek bulundu. Fio2 ve PIP ortalamaları PNX (+) olan grupta anlamlı olarak daha yüksek tespit edildi (p=0.000). PNX (+) olan grupta yoğun bakım yatış süreleri (p=0.003) ve hastane yatış süreleri (p=0.015) anlamlı daha yüksek tespit edildi.Sonuç: Pnömotoraks COVID-19 pnömonisi olan hastalarda daha sık gözükmekte, hastane yatış süresi / yoğun bakım yatış sürelerini uzatmakta ve mortalite oranlarında artışa neden olmaktadır.

Anahtar Kelimeler:

Pnömotoraks, Covid-19, Yoğun Bakım Ünitesi, Prognoz

Effects of pneumothorax on patient’s prognosis with COVID-19 in the intensive care unit

Background: In this study, it was aimed to investigate the relationship between pneumothorax (PNX) and the prognosis of COVID-19-positive patients in the intensive care unit (ICU).

Keywords:

Pneumotorax, Covid-19, İntensive Care Unıt, Prognosis,

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Akdogan, R.E., Mohammed, T., Syeda, A., Jiwa, N., Ibrahim, O. & Mutneja, R. (2021). Pneumothorax in mechanically ventilated patients with COVID-19 infection. Case Reports in Critical Care, 2021, 6657533.
Belletti, A., Palumbo, D., Zangrillo, A., Fominskiy, E. V., Franchini, S., Dell’Acqua, A., …& De Cobelli, F. (2021). Predictors of pneumothorax/ pneumomediastinum in mechanically ventilated COVID-19 patients. Journal of Cardiothoracic and Vascular Anesthesia, 35(12), 3642–3651.
Capaccione, K. M., ’souza, D. & Leb, B. (2021). Pneumothorax rate in intubated patients with COVID-19. Acute Crit Care, 36(1), 81–84.
Chopra, A., Al-Tarbsheh, A.H., Shah, N.J., Yaqoob, H., Hu, K., Feustel, P.J., …& Judson, M.A. (2021). Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study. Respiratory Medicine, 184(106464), 106464.
Marciniak, S.J., Farrell, J., Rostron, A., Smith, I., Openshaw, P.J.M., Baillie, J.K., …& Semple, M.G. (2021). COVID-19 pneumothorax in the UK: a prospective observational study using the ISARIC WHO clinical characterisation protocol. The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 58(3), 2100929.
Martinelli, A. W., Ingle, T., Newman, J., Nadeem, I., Jackson, K., Lane, N. D., …& Marciniak, S.J. (2020). COVID-19 and pneumothorax: a multicentre retrospective case series. The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology, 56(5), 2002697.
McGuinness, G., Zhan, C., Rosenberg, N., Azour, L., Wickstrom, M., Mason, D.M., … Moore, W.H. (2020). Increased incidence of barotrauma in patients with COVID-19 on invasive mechanical ventilation. Radiology, 297(2), E252–E262.
Nishikimi, M., Jafari, D., Singh, N., Shinozaki, K., Sison, C. P., Shoaib, M. & Becker, L. B. (2022). Northwell health COVID-19 research consortium. mortality of mechanically ventilated COVID-19 patients in traditional versus expanded intensive care units (Vol. 19). New York: Ann Am Thorac Soc, 19(8), 1346-1354.
Roberts, D.J., Leigh-Smith, S., Faris, P.D., Blackmore, C., Ball, C. G., Robertson, H.L., …& Stelfox, H.T. (2015). Clinical presentation of patients with tension pneumothorax: A systematic review. Annals of Surgery, 261(6), 1068–1078.
Sihoe, A.D., Wong, R.H. & Lee, A.T. (2004). Severe acute respiratory syndrome complicated by spontaneous pneumothorax. Chest, 125(6), 2345–2351.
Udwadia, Z.F., Toraskar, K.K., Pinto, L., Mullerpatan, J., Wagh, H. D., Mascarenhas, J. M.… & Gupta, G.A. (2021). Increased frequency of pneumothorax and pneumomediastinum in COVID-19 patients admitted in the ICU: A multicentre study from Mumbai, India. Clinical Medicine (London, England), 21(6), e615–e619.
Wang, X.-H., Duan, J., Han, X., Liu, X., Zhou, J., Wang, X. …& Guo, S. (2021). High incidence and mortality of pneumothorax in critically Ill patients with COVID-19. Heart & Lung: The Journal of Critical Care, 50(1), 37–43.
Xu, Z., Shi, L., Wang, Y., Zhang, J., Huang, L., Zhang, C. & Wang, F.-S. (2020). Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet. Respiratory Medicine, 8(4), 420–422.
Yakar, M.N., Ergan, B., Ergün, B., Küçük, M., Cantürk, A., Ergon, M.C. …& Gökmen, A.N. (2021). Clinical characteristics and risk factors for 28-day mortality in critically ill patients with COVID-19: a retrospective cohort study. Turkish Journal of Medical Sciences, 51(5), 2285–2295.