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Pneumothorax and mortality in the mechanically ventilated SARS patients: a prospective clinical study.
Crit Care. 2005 Aug; 9(4):R440-5.CC

Abstract

INTRODUCTION

Pneumothorax often complicates the management of mechanically ventilated severe acute respiratory syndrome (SARS) patients in the isolation intensive care unit (ICU). We sought to determine whether pneumothoraces are induced by high ventilatory pressure or volume and if they are associated with mortality in mechanically ventilated SARS patients.

METHODS

We conducted a prospective, clinical study. Forty-one mechanically ventilated SARS patients were included in our study. All SARS patients were sedated and received mechanical ventilation in the isolation ICU.

RESULTS

The mechanically ventilated SARS patients were divided into two groups either with or without pneumothorax. Their demographic data, clinical characteristics, ventilatory variables such as positive end-expiratory pressure, peak inspiratory pressure, mean airway pressure, tidal volume, tidal volume per kilogram, respiratory rate and minute ventilation and the accumulated mortality rate at 30 days after mechanical ventilation were analyzed. There were no statistically significant differences in the pressures and volumes between the two groups, and the mortality was also similar between the groups. However, patients developing pneumothorax during mechanical ventilation frequently expressed higher respiratory rates on admission, and a lower PaO2/FiO2 ratio and higher PaCO2 level during hospitalization compared with those without pneumothorax.

CONCLUSION

In our study, the SARS patients who suffered pneumothorax presented as more tachypnic on admission, and more pronounced hypoxemic and hypercapnic during hospitalization. These variables signaled a deterioration in respiratory function and could be indicators of developing pneumothorax during mechanical ventilation in the SARS patients. Meanwhile, meticulous respiratory therapy and monitoring were mandatory in these patients.

Authors+Show Affiliations

Department of Respiratory Therapy, Taipei Veterans General Hospital, Taiwan. kuohsink@ms67.hinet.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16137358

Citation

Kao, Hsin-Kuo, et al. "Pneumothorax and Mortality in the Mechanically Ventilated SARS Patients: a Prospective Clinical Study." Critical Care (London, England), vol. 9, no. 4, 2005, pp. R440-5.
Kao HK, Wang JH, Sung CS, et al. Pneumothorax and mortality in the mechanically ventilated SARS patients: a prospective clinical study. Crit Care. 2005;9(4):R440-5.
Kao, H. K., Wang, J. H., Sung, C. S., Huang, Y. C., & Lien, T. C. (2005). Pneumothorax and mortality in the mechanically ventilated SARS patients: a prospective clinical study. Critical Care (London, England), 9(4), R440-5.
Kao HK, et al. Pneumothorax and Mortality in the Mechanically Ventilated SARS Patients: a Prospective Clinical Study. Crit Care. 2005;9(4):R440-5. PubMed PMID: 16137358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumothorax and mortality in the mechanically ventilated SARS patients: a prospective clinical study. AU - Kao,Hsin-Kuo, AU - Wang,Jia-Horng, AU - Sung,Chun-Sung, AU - Huang,Ying-Che, AU - Lien,Te-Cheng, Y1 - 2005/06/22/ PY - 2005/03/16/received PY - 2005/04/27/revised PY - 2005/05/12/accepted PY - 2005/9/3/pubmed PY - 2006/9/27/medline PY - 2005/9/3/entrez SP - R440 EP - 5 JF - Critical care (London, England) JO - Crit Care VL - 9 IS - 4 N2 - INTRODUCTION: Pneumothorax often complicates the management of mechanically ventilated severe acute respiratory syndrome (SARS) patients in the isolation intensive care unit (ICU). We sought to determine whether pneumothoraces are induced by high ventilatory pressure or volume and if they are associated with mortality in mechanically ventilated SARS patients. METHODS: We conducted a prospective, clinical study. Forty-one mechanically ventilated SARS patients were included in our study. All SARS patients were sedated and received mechanical ventilation in the isolation ICU. RESULTS: The mechanically ventilated SARS patients were divided into two groups either with or without pneumothorax. Their demographic data, clinical characteristics, ventilatory variables such as positive end-expiratory pressure, peak inspiratory pressure, mean airway pressure, tidal volume, tidal volume per kilogram, respiratory rate and minute ventilation and the accumulated mortality rate at 30 days after mechanical ventilation were analyzed. There were no statistically significant differences in the pressures and volumes between the two groups, and the mortality was also similar between the groups. However, patients developing pneumothorax during mechanical ventilation frequently expressed higher respiratory rates on admission, and a lower PaO2/FiO2 ratio and higher PaCO2 level during hospitalization compared with those without pneumothorax. CONCLUSION: In our study, the SARS patients who suffered pneumothorax presented as more tachypnic on admission, and more pronounced hypoxemic and hypercapnic during hospitalization. These variables signaled a deterioration in respiratory function and could be indicators of developing pneumothorax during mechanical ventilation in the SARS patients. Meanwhile, meticulous respiratory therapy and monitoring were mandatory in these patients. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/16137358/Pneumothorax_and_mortality_in_the_mechanically_ventilated_SARS_patients:_a_prospective_clinical_study_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc3736 DB - PRIME DP - Unbound Medicine ER -