Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors
The incidence of mediastinal emphysema (ME) and pneumothorax (PTX) was analyzed to determine the roentgenographic patterns and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms of 139 intubated patients admitted to our medical inte...
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| Veröffentlicht in: | Chest 1992-08, Vol.102 (2), p.568-572 |
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| creator | BRUCE GAMMON, R SHIN, M. S BUCHALTER, S. E |
| description | The incidence of mediastinal emphysema (ME) and pneumothorax (PTX) was analyzed to determine the roentgenographic patterns
and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms
of 139 intubated patients admitted to our medical intensive care unit over a ten-month period were evaluated for the presence
of ME and PTX. Barotrauma was diagnosed in 34 of these patients, and ME was the initial manifestation in 24 patients. Of these
patients with initial ME, ten subsequently developed PTX, a positive predictive value of 42 percent. The adult respiratory
distress syndrome (ARDS) patient population was at highest risk for barotrauma, with an intermediate risk seen in those admitted
with COPD or pneumonia. Values of peak inspiratory pressure, positive end-expiratory pressure level, respiratory rate, tidal
volume, and minute ventilation were significantly elevated in patients who developed barotrauma as compared with patients
who did not develop barotrauma. However, these elevations in part reflect the high incidence of barotrauma in the ARDS population,
a patient group in which all of the above parameters were elevated. |
| doi_str_mv | 10.1378/chest.102.2.568 |
| format | Article |
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and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms
of 139 intubated patients admitted to our medical intensive care unit over a ten-month period were evaluated for the presence
of ME and PTX. Barotrauma was diagnosed in 34 of these patients, and ME was the initial manifestation in 24 patients. Of these
patients with initial ME, ten subsequently developed PTX, a positive predictive value of 42 percent. The adult respiratory
distress syndrome (ARDS) patient population was at highest risk for barotrauma, with an intermediate risk seen in those admitted
with COPD or pneumonia. Values of peak inspiratory pressure, positive end-expiratory pressure level, respiratory rate, tidal
volume, and minute ventilation were significantly elevated in patients who developed barotrauma as compared with patients
who did not develop barotrauma. However, these elevations in part reflect the high incidence of barotrauma in the ARDS population,
a patient group in which all of the above parameters were elevated.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.102.2.568</identifier><identifier>PMID: 1643949</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: American College of Chest Physicians</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Artificial respiration ; Barotrauma - diagnosis ; Barotrauma - epidemiology ; Barotrauma - etiology ; Barotrauma - mortality ; Biological and medical sciences ; Complications and side effects ; Decompression sickness ; Development and progression ; Diagnosis, Radioscopic ; Emergency and intensive respiratory care ; Emphysema, Pulmonary ; Humans ; Incidence ; Intensive care medicine ; Lung - diagnostic imaging ; Lung - physiopathology ; Lung Injury ; Mediastinal Emphysema - diagnosis ; Mediastinal Emphysema - epidemiology ; Mediastinal Emphysema - etiology ; Mediastinal Emphysema - mortality ; Medical sciences ; Pneumothorax ; Pneumothorax - diagnosis ; Pneumothorax - epidemiology ; Pneumothorax - etiology ; Pneumothorax - mortality ; Radiography ; Respiration, Artificial - adverse effects ; Respiration, Artificial - statistics & numerical data ; Respiratory Function Tests ; Risk Factors</subject><ispartof>Chest, 1992-08, Vol.102 (2), p.568-572</ispartof><rights>1992 INIST-CNRS</rights><rights>COPYRIGHT 1992 Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5556483$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1643949$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BRUCE GAMMON, R</creatorcontrib><creatorcontrib>SHIN, M. S</creatorcontrib><creatorcontrib>BUCHALTER, S. E</creatorcontrib><title>Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors</title><title>Chest</title><addtitle>Chest</addtitle><description>The incidence of mediastinal emphysema (ME) and pneumothorax (PTX) was analyzed to determine the roentgenographic patterns
and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms
of 139 intubated patients admitted to our medical intensive care unit over a ten-month period were evaluated for the presence
of ME and PTX. Barotrauma was diagnosed in 34 of these patients, and ME was the initial manifestation in 24 patients. Of these
patients with initial ME, ten subsequently developed PTX, a positive predictive value of 42 percent. The adult respiratory
distress syndrome (ARDS) patient population was at highest risk for barotrauma, with an intermediate risk seen in those admitted
with COPD or pneumonia. Values of peak inspiratory pressure, positive end-expiratory pressure level, respiratory rate, tidal
volume, and minute ventilation were significantly elevated in patients who developed barotrauma as compared with patients
who did not develop barotrauma. However, these elevations in part reflect the high incidence of barotrauma in the ARDS population,
a patient group in which all of the above parameters were elevated.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Artificial respiration</subject><subject>Barotrauma - diagnosis</subject><subject>Barotrauma - epidemiology</subject><subject>Barotrauma - etiology</subject><subject>Barotrauma - mortality</subject><subject>Biological and medical sciences</subject><subject>Complications and side effects</subject><subject>Decompression sickness</subject><subject>Development and progression</subject><subject>Diagnosis, Radioscopic</subject><subject>Emergency and intensive respiratory care</subject><subject>Emphysema, Pulmonary</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intensive care medicine</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - physiopathology</subject><subject>Lung Injury</subject><subject>Mediastinal Emphysema - diagnosis</subject><subject>Mediastinal Emphysema - epidemiology</subject><subject>Mediastinal Emphysema - etiology</subject><subject>Mediastinal Emphysema - mortality</subject><subject>Medical sciences</subject><subject>Pneumothorax</subject><subject>Pneumothorax - diagnosis</subject><subject>Pneumothorax - epidemiology</subject><subject>Pneumothorax - etiology</subject><subject>Pneumothorax - mortality</subject><subject>Radiography</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Respiratory Function Tests</subject><subject>Risk Factors</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkb1v2zAQxYkiQeo4nTsF0BB0ihR-iBQ5BkY_DBhohmQmThRlM6Eol5RS9L8vXRudjBuI4_1wuPceQp8Jrghr5IPZ2TRVBNOKVlzID2hBFCMl4zW7QAuMCS2ZUPQjuk7pFeeeKHGFroiomarVAq2fZj-MAeKfooU4ThHmAQoXisGaHQRnwBfvNkzOw-TGUBVPME02hlRA6Iro0lvRg5nGmG7QZQ8-2U-nd4levn19Xv0oNz-_r1ePm3LLOJ5KLilQ0bSE9tLIlvV11wEWkmOhoGmwpBiMgZZCW7NWKcJr1dUYC9w1hHHGlujLce8-jr_mrF4PLhnrPQQ7zkk3jBBKqMzg_RHcgrfahf6gzmxtsBH8GGzv8vcjoVwxyQ94eQbP1dnBmXP87emOuR1sp_fRDdlGfbI2z-9Oc0jZxT5CMC79xzjnopYHOQ9HbOe2u98uWp0G8D4vZfpfuK_jHAP4HLGmOkfM_gJpZ5f8</recordid><startdate>19920801</startdate><enddate>19920801</enddate><creator>BRUCE GAMMON, R</creator><creator>SHIN, M. S</creator><creator>BUCHALTER, S. E</creator><general>American College of Chest Physicians</general><general>Elsevier B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19920801</creationdate><title>Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors</title><author>BRUCE GAMMON, R ; SHIN, M. S ; BUCHALTER, S. E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g350t-582a267b12f8c8b3f4dda0685069a770820accab2ab43b991549d40060d713533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Artificial respiration</topic><topic>Barotrauma - diagnosis</topic><topic>Barotrauma - epidemiology</topic><topic>Barotrauma - etiology</topic><topic>Barotrauma - mortality</topic><topic>Biological and medical sciences</topic><topic>Complications and side effects</topic><topic>Decompression sickness</topic><topic>Development and progression</topic><topic>Diagnosis, Radioscopic</topic><topic>Emergency and intensive respiratory care</topic><topic>Emphysema, Pulmonary</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intensive care medicine</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - physiopathology</topic><topic>Lung Injury</topic><topic>Mediastinal Emphysema - diagnosis</topic><topic>Mediastinal Emphysema - epidemiology</topic><topic>Mediastinal Emphysema - etiology</topic><topic>Mediastinal Emphysema - mortality</topic><topic>Medical sciences</topic><topic>Pneumothorax</topic><topic>Pneumothorax - diagnosis</topic><topic>Pneumothorax - epidemiology</topic><topic>Pneumothorax - etiology</topic><topic>Pneumothorax - mortality</topic><topic>Radiography</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Respiratory Function Tests</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BRUCE GAMMON, R</creatorcontrib><creatorcontrib>SHIN, M. S</creatorcontrib><creatorcontrib>BUCHALTER, S. E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BRUCE GAMMON, R</au><au>SHIN, M. S</au><au>BUCHALTER, S. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1992-08-01</date><risdate>1992</risdate><volume>102</volume><issue>2</issue><spage>568</spage><epage>572</epage><pages>568-572</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>The incidence of mediastinal emphysema (ME) and pneumothorax (PTX) was analyzed to determine the roentgenographic patterns
and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms
of 139 intubated patients admitted to our medical intensive care unit over a ten-month period were evaluated for the presence
of ME and PTX. Barotrauma was diagnosed in 34 of these patients, and ME was the initial manifestation in 24 patients. Of these
patients with initial ME, ten subsequently developed PTX, a positive predictive value of 42 percent. The adult respiratory
distress syndrome (ARDS) patient population was at highest risk for barotrauma, with an intermediate risk seen in those admitted
with COPD or pneumonia. Values of peak inspiratory pressure, positive end-expiratory pressure level, respiratory rate, tidal
volume, and minute ventilation were significantly elevated in patients who developed barotrauma as compared with patients
who did not develop barotrauma. However, these elevations in part reflect the high incidence of barotrauma in the ARDS population,
a patient group in which all of the above parameters were elevated.</abstract><cop>Northbrook, IL</cop><pub>American College of Chest Physicians</pub><pmid>1643949</pmid><doi>10.1378/chest.102.2.568</doi><tpages>5</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Artificial respiration Barotrauma - diagnosis Barotrauma - epidemiology Barotrauma - etiology Barotrauma - mortality Biological and medical sciences Complications and side effects Decompression sickness Development and progression Diagnosis, Radioscopic Emergency and intensive respiratory care Emphysema, Pulmonary Humans Incidence Intensive care medicine Lung - diagnostic imaging Lung - physiopathology Lung Injury Mediastinal Emphysema - diagnosis Mediastinal Emphysema - epidemiology Mediastinal Emphysema - etiology Mediastinal Emphysema - mortality Medical sciences Pneumothorax Pneumothorax - diagnosis Pneumothorax - epidemiology Pneumothorax - etiology Pneumothorax - mortality Radiography Respiration, Artificial - adverse effects Respiration, Artificial - statistics & numerical data Respiratory Function Tests Risk Factors |
| title | Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors |
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