Pneumothorax in Ventilated Patients

A new study has revealed that patients with severe acute respiratory syndrome (SARS) who have a higher respiratory rate upon admission to a hospital have a higher risk of pneumothorax. The findings were reported in the June 22, 2005, issue of Critical Care.

Pnemothorax often complicates the management of mechanically ventilated SARS patients in an isolation intensive care unit (ICU). Researchers at the Taipei Veterans General Hospital (Taiwan) sought to determine whether pneumothoraxes are induced by high ventilatory pressure or volume and if they are associated with mortality in mechanically ventilated SARS patients.

A clinical study led by Dr. Hsin-Kuo Kao was made of 41 SARS patients. All were sedated and received mechanical ventilation in the isolation ICU. The mechanically ventilated SARS patients were divided into two groups: either with or without pneumothorax. The researchers found no differences in the ventilatory variables and volumes between the two groups. However, patients who developed pneumothorax during mechanical ventilation frequently expressed higher respiratory rates on admission, a lower ratio of arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2), and a higher PaCO2 level during hospitalization, compared to patients without pneumothorax.

The SARS patients who suffered pneumothorax presented as more tachypnic on admission, and more pronounced hypoxemic and hypercapnic during hospitalization—which signaled a deterioration in respiratory function and could be indicators of developing pneumothorax during mechanical ventilation in the SARS patients.






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Taipei Veterans General Hospital