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Is continuous positive airway pressure therapy in COVID-19 associated with an increased rate of pulmonary barotrauma?

Lewis Jones, Rebecca Nightingale, Hassan Burhan, Gareth Jones, Kimberley Barber, Helena Bond, Robert Parker, Nick Duffy, Peter Hampshire, Manish Gautam
ERJ Open Research 2021 7: 00886-2020; DOI: 10.1183/23120541.00886-2020
Lewis Jones
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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  • For correspondence: @liverpoolft.nhs.uk
Rebecca Nightingale
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
2Liverpool School of Tropical Medicine, Liverpool, UK
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  • ORCID record for Rebecca Nightingale
Hassan Burhan
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
2Liverpool School of Tropical Medicine, Liverpool, UK
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  • ORCID record for Hassan Burhan
Gareth Jones
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Kimberley Barber
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Helena Bond
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Robert Parker
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Nick Duffy
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Peter Hampshire
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Manish Gautam
1Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
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Tables

  • TABLE 1

    Characteristics of COVID-19 patients on continuous positive airway pressure (CPAP) with pulmonary barotrauma: wave 2

    Summary
     Patients receiving CPAP, n136
     Barotrauma cases, n9
     Incidence, %6.6
    Demographics
     Age, years, median (range)64 (27–82)
     Male/female, n6/3
     BMI, kg·m−2, median (range)28 (24–36)
     Never-smoker/ex-smoker, n6/3
     Underlying respiratory diagnosis, n
      None7
      Asthma1
      Pleural plaques1
    Baseline characteristics before commencing CPAP
     Respiratory rate, breaths·min−1, median (mean; range)28 (29.5; 20–40)#
     PaO2/FIO2 ratio, mmHg, median (mean; range)72 (80.0; 55–122)
    CPAP therapy
     Time from commencing CPAP to barotrauma diagnosis, days, median (range)6 (3–10)
     Maximum CPAP pressure received, cmH2O, median (range)12.5 (10–15)
    Barotrauma cases
     Bilateral/unilateral pneumothorax, n4/1
     Requirement of intercostal chest drain insertion, n3
     Pneumomediastinum, n9
     Surgical emphysema (radiological diagnosis), n8
     Outcome, n
      Died5
      Inpatient1
      Discharged3

    COVID-19: coronavirus disease 2019; BMI: body mass index; PaO2: arterial oxygen tension; FIO2: inspiratory oxygen fraction. #: data available for eight out of nine patients.

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    Is continuous positive airway pressure therapy in COVID-19 associated with an increased rate of pulmonary barotrauma?
    Lewis Jones, Rebecca Nightingale, Hassan Burhan, Gareth Jones, Kimberley Barber, Helena Bond, Robert Parker, Nick Duffy, Peter Hampshire, Manish Gautam
    ERJ Open Research Oct 2021, 7 (4) 00886-2020; DOI: 10.1183/23120541.00886-2020

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    Is continuous positive airway pressure therapy in COVID-19 associated with an increased rate of pulmonary barotrauma?
    Lewis Jones, Rebecca Nightingale, Hassan Burhan, Gareth Jones, Kimberley Barber, Helena Bond, Robert Parker, Nick Duffy, Peter Hampshire, Manish Gautam
    ERJ Open Research Oct 2021, 7 (4) 00886-2020; DOI: 10.1183/23120541.00886-2020
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