Barotrauma in COVID-19 patients requiring oxygen: a single-center retrospective study in Vietnam

Background: This study aimed to investigate the incidence, risk factors, and outcomes associated with barotrauma in coronavirus disease 2019 (COVID-19) patients who required oxygen support, specifically using high-flow nasal cannula (HFNC) and invasive mechanical ventilation (IMV). The authors also explored intervention strategies for the management of barotrauma and its impact on mortality risk. Methods: The retrospective study included a total of 381 patients with COVID-19 who required treatment in the ICU and received oxygen therapy via HFNC and IMV between July 2021 and October 2021. Retrospective data collection was conducted to record patient outcomes, including survival upon discharge from the ICU or in-ICU mortality. Results: Among the 381 patients, 203 received IMV, while 178 were placed on HFNC ventilation. The average age of our patient cohort was 62.1 years +/- 15, with females constituting 54.1% of the study population. The incidence of barotrauma was observed in 8.7% of cases. Patients with barotrauma experienced a 3.3-fold increase in mortality rates and a statistically significant prolongation of their ICU stay. Notably, there was no significant difference in the 90-day survival rate between the groups with and without barotrauma. Conclusion: Barotrauma is a common complication in COVID-19 patients receiving mechanical ventilation. In comparison to intubated COVID-19 patients without barotrauma, those with barotrauma face an increased risk of mortality and prolonged ICU stays.