Journal of Medical and Surgical Intensive Care Medicine 2017 , Vol 8, Issue 2
Barotrauma Associated with Mechanical Ventilation
Funda Elmas Uysal 1 , Pervin Korkmaz Ekren 1 , Feza Bacakoğlu 1 , Atilla Kuntman 2
1Ege Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İzmir, Türkiye
2Ege Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yoğun Bakım Bilim Dalı, İzmir, Türkiye
DOI : 10.5152/dcbybd.2017.1496

Objective: The incidence of barotrauma in patients who received mechanical ventilation (MV) has decreased due to protective MV strategies. This study aimed to assess the incidence, treatment, and prognosis of barotrauma in patients who received MV in our tertiary intensive care unit (ICU) and to discuss with the literature.

Material and Methods: Patients hospitalized between January 2008 and December 2014 were assessed. Those who had barotrauma were retrospectively analyzed.

Results: Invasive MV was performed in 861 of 1341 patients. Barotrauma was seen in 19 (2.2%) patients. These patients’ (mean age, 63.2±18.2 years; 14 males) median APACHE II score was 18, and their median duration of MV was 168 h. Acute Respiratory Distress Syndrome(ARDS) was diagnosed in 57.9% of the patients at admission, and volume-controlled ventilation was mostly used (47.4%). Barotrauma occurred on day 8 (median; range, day 4–21). Pneumonia was diagnosed in 84.2% of the patients. Pressure support ventilation was mostly used (47.4%) at the time of barotrauma. All patients had pneumomediastinum. Pneumothorax was diagnosed in 16 (84.2%) patients (bilaterally in 3 patients). Subcutaneous emphysema was seen in 11 patients (57.9%). Pneumothorax was treated by tube thoracostomy in 15 patients (83.3%). While the mortality rate was 26.3% in first 24 h, the overall mortality rate was 100%. 

Conclusion: The incidence of barotrauma was lower among our ICU patients who received MV, but the prognosis of these patients was poor.

Cite this article as: Elmas Uysal F, Korkmaz Ekren P, Kuntman A, et al. Barotrauma Associated with Mechanical Ventilation. Yoğun Bakım Derg 2017; 8: 39-43.

Keywords : Barotrauma, invasive mechanical ventilation, treatment, prognosis