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Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome

BACKGROUND: Numerous complications requiring tube thoracostomy have been reported among critically ill patients with COVID-19; however, there has been a lack of evidence regarding outcomes following chest tube placement. METHODS: We developed a retrospective observational cohort of all patients admi...

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Autores principales: Rizer, Nicholas W., Smood, Benjamin, Mergler, Blake, Sperry, Alexandra E., Bermudez, Christian A., Gutsche, Jacob T., Usman, Asad A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9020834/
https://www.ncbi.nlm.nih.gov/pubmed/35469265
http://dx.doi.org/10.1016/j.xjon.2022.03.008
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author Rizer, Nicholas W.
Smood, Benjamin
Mergler, Blake
Sperry, Alexandra E.
Bermudez, Christian A.
Gutsche, Jacob T.
Usman, Asad A.
author_facet Rizer, Nicholas W.
Smood, Benjamin
Mergler, Blake
Sperry, Alexandra E.
Bermudez, Christian A.
Gutsche, Jacob T.
Usman, Asad A.
author_sort Rizer, Nicholas W.
collection PubMed
description BACKGROUND: Numerous complications requiring tube thoracostomy have been reported among critically ill patients with COVID-19; however, there has been a lack of evidence regarding outcomes following chest tube placement. METHODS: We developed a retrospective observational cohort of all patients admitted to an intensive care unit (ICU) with confirmed COVID-19 to describe the incidence of tube thoracostomy and factors associated with mortality following chest tube placement. RESULTS: In total, 1705 patients with laboratory confirmed COVID-19 patients were admitted to our ICUs from March 7, 2020, to March 1, 2021, with 69 out of 1705 patients (4.0%) receiving 130 chest tubes. Of these, 89 out of 130 (68%) chest tubes were indicated for pneumothorax. Patients receiving tube thoracostomy were much less likely to be alive 90 days post-ICU admission (52% vs 69%; P < .01), and had longer ICU (30 vs 5 days; P < .01) and hospital (37 vs 10 days; P < .01) lengths of stay compared with those without tube thoracostomy. Patients who received tube thoracostomy and survived at least 90 days post-ICU admission had shorter times to first chest tube insertion (8.5 vs 17.0 days; P = .01) and a nonsignificantly higher static compliance (20.0 vs 17.5 mL/cm H(2)O; P = .052) at the time of chest tube placement than those who had expired. Logistic regression analysis demonstrated an association between time to first chest tube and decreased survival when adjusted for covariates. CONCLUSIONS: Requiring a chest tube in COVID-19 is a negative prognostic end point. Delayed development of chest tube requirement was associated with a decreased survival and could reflect a poor healing phenotype.
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spelling pubmed-90208342022-04-21 Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome Rizer, Nicholas W. Smood, Benjamin Mergler, Blake Sperry, Alexandra E. Bermudez, Christian A. Gutsche, Jacob T. Usman, Asad A. JTCVS Open Thoracic: Perioperative Management BACKGROUND: Numerous complications requiring tube thoracostomy have been reported among critically ill patients with COVID-19; however, there has been a lack of evidence regarding outcomes following chest tube placement. METHODS: We developed a retrospective observational cohort of all patients admitted to an intensive care unit (ICU) with confirmed COVID-19 to describe the incidence of tube thoracostomy and factors associated with mortality following chest tube placement. RESULTS: In total, 1705 patients with laboratory confirmed COVID-19 patients were admitted to our ICUs from March 7, 2020, to March 1, 2021, with 69 out of 1705 patients (4.0%) receiving 130 chest tubes. Of these, 89 out of 130 (68%) chest tubes were indicated for pneumothorax. Patients receiving tube thoracostomy were much less likely to be alive 90 days post-ICU admission (52% vs 69%; P < .01), and had longer ICU (30 vs 5 days; P < .01) and hospital (37 vs 10 days; P < .01) lengths of stay compared with those without tube thoracostomy. Patients who received tube thoracostomy and survived at least 90 days post-ICU admission had shorter times to first chest tube insertion (8.5 vs 17.0 days; P = .01) and a nonsignificantly higher static compliance (20.0 vs 17.5 mL/cm H(2)O; P = .052) at the time of chest tube placement than those who had expired. Logistic regression analysis demonstrated an association between time to first chest tube and decreased survival when adjusted for covariates. CONCLUSIONS: Requiring a chest tube in COVID-19 is a negative prognostic end point. Delayed development of chest tube requirement was associated with a decreased survival and could reflect a poor healing phenotype. Elsevier 2022-04-20 /pmc/articles/PMC9020834/ /pubmed/35469265 http://dx.doi.org/10.1016/j.xjon.2022.03.008 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Thoracic: Perioperative Management
Rizer, Nicholas W.
Smood, Benjamin
Mergler, Blake
Sperry, Alexandra E.
Bermudez, Christian A.
Gutsche, Jacob T.
Usman, Asad A.
Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title_full Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title_fullStr Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title_full_unstemmed Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title_short Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome
title_sort reduced survival in patients requiring chest tubes with covid-19 acute respiratory distress syndrome
topic Thoracic: Perioperative Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9020834/
https://www.ncbi.nlm.nih.gov/pubmed/35469265
http://dx.doi.org/10.1016/j.xjon.2022.03.008
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