Document Detail

Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors.
MedLine Citation:
PMID:  1643949     Owner:  NLM     Status:  MEDLINE    
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.
R B Gammon; M S Shin; S E Buchalter
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  102     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-08     Completed Date:  1992-09-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  568-72     Citation Subset:  AIM; IM    
Department of Medicine, University of Alabama, Birmingham.
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MeSH Terms
Barotrauma / diagnosis,  epidemiology,  etiology*,  mortality
Lung / physiopathology,  radiography
Lung Injury*
Mediastinal Emphysema / diagnosis,  epidemiology,  etiology,  mortality
Pneumothorax / diagnosis,  epidemiology,  etiology,  mortality
Respiration, Artificial / adverse effects*,  statistics & numerical data
Respiratory Function Tests
Risk Factors
Comment In:
Chest. 1993 Sep;104(3):987   [PMID:  8365343 ]

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