• Alessandro Protti, Massimiliano Greco, Matteo Filippini, Anna M Vilardo, Thomas Langer, Martina Villa, Fernando Frutos-Vivar, Alessandro Santini, Pier F Caruso, Sofia Spano, Antonio Anzueto, Giuseppe Citerio, Giacomo Bellani, Giuseppe Foti, Roberto Fumagalli, Antonio Pesenti, Giacomo Grasselli, and Maurizio Cecconi.
• Department of Anesthesiology and Intensive Care Units, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
• Minerva Anestesiol. 2021 Feb 1; 87 (2): 193-198.

BackgroundThe aim was to describe the incidence and risk factors of barotrauma in patients with the Coronavirus disease 2019 (COVID-19) on invasive mechanical ventilation, during the outbreak in our region (Lombardy, Italy).MethodsThe study was an electronic survey open from March 27th to May 2nd, 2020. Patients with COVID-19 who developed barotrauma while on invasive mechanical ventilation from 61 hospitals of the COVID-19 Lombardy Intensive Care Unit network were involved.ResultsThe response rate was 38/61 (62%). The incidence of barotrauma was 145/2041 (7.1%; 95%-CI: 6.1-8.3%). Only a few cases occurred with ventilatory settings that may be considered non-protective such as a plateau airway pressure >35 cmH2O (2/113 [2%]), a driving airway pressure >15 cmH2O (30/113 [27%]), or a tidal volume >8 mL/kg of ideal body weight and a plateau airway pressure >30 cmH2O (12/134 [9%]).ConclusionsWithin the limits of a survey, patients with COVID-19 might be at high risk for barotrauma during invasive (and allegedly lung-protective) mechanical ventilation.

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