Respiratory failure & ventilation
A descriptive, retrospective single‐centre study of air‐leak syndrome in intensive care unit patients with COVID‐19
Authors' conclusion
In 669 ICU patients with COVID-19, 12% had one or more manifestations of air-leak syndrome. Notably, PMD, rather than PTX, was the most common manifestation, suggesting a potentially distinctive feature of COVID-19-related air-leak syndrome.
Study context
- Population
- Adults admitted to an intensive care unit (ICU) for COVID-19-related respiratory failure at Södersjukhuset, Sweden, March 6, 2020–June 6, 2021
- Participants
- 669 adults
- Exposure
- Air-leak syndrome vs no air-leak syndrome
- Air-leak syndromen = 81
- Outcome
- Proportion diagnosed with air-leak syndrome and its types of manifestation; timing of diagnosis in relation to ICU admission and start of invasive ventilation
Methodological detailsdescriptive, single-centre
- Descriptive
- Single-centre
Main finding
As reported in the abstract
Air-leak syndrome: prevalence, type and timing
- Diagnosed with air-leak syndrome
- 81 (12%)
- Pneumomediastinum (PMD)
- n = 58, 72%
- Pneumothorax (PTX)
- n = 43, 53%
- Subcutaneous emphysema (SCE)
- n = 28, 35%
- Pneumatocele (PC)
- n = 4, 4.9%
- Median days from ICU admission to diagnosis
- 14 days (IQR 6-22)
- Median days from start of invasive ventilation to diagnosis
- 12 days (IQR 6-19)
Observational data: associations, not effects.
Secondary outcomes
Factors associated with air-leak syndrome (multiple logistic regression)
| OR (95% CI) | ||
|---|---|---|
| Pulmonary disease at baseline | 1.87 (1.07–3.25) | |
| BMI (lower) | 0.95 (0.9–0.99) | |
| IV | 3.92 (2.07–7.44) | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| Factors associated with air-leak syndrome (multiple logistic regression)Admission later in pandemic vs Earlier admission | 3.89 (2.14–7.08) | |
| 0.10.31310Odds ratio (log scale) |
Mortality · 90 days after ICU admission
P < 0.001
Highest respiratory support before air-leak diagnosis
- Invasive ventilation (IV)
- 64 patients (79%)
- NIV
- two patients (2.5%)
- Low- or high-flow oxygen
- 15 patients (19%)
Mortality by air-leak manifestation (subgroup) · 90 days
- PMD
- 47%
- PTX
- 47%
- PMD and PTX combined
- 50%
- Only SCE and/or PC
- 0%
Original publication
A descriptive, retrospective single‐centre study of air‐leak syndrome in intensive care unit patients with COVID‐19. Acta Anaesthesiol Scand. Published 12 February 2025. doi:10.
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