Critically ill COVID-19 patients have to undergo positive pressure ventilation, a non-physiological and invasive intervention that can be lifesaving in severe ARDS. Similar to any other intervention, it has its pros and cons. Despite following Lung Protective Ventilation (LPV), some of the complications are frequently reported in these critically ill patients and significantly impact overall mortality. The complications related to invasive mechanical ventilation (IMV) in critically ill COVID-19 patients can be broadly divided into pulmonary and non-pulmonary. Among pulmonary complications, the most frequent is ventilator-associated pneumonia. Others are barotrauma, including subcutaneous emphysema, pneumomediastinum, pneumothorax, bullous lesions, cardiopulmonary effects of right ventricular dysfunction, and pulmonary complications mimicking cardiac failure, including pulmonary edema. Tracheal complications, including full-thickness tracheal lesions (FTTLs) and tracheoesophageal fistulas (TEFs) are serious but rare complications. Non-Pulmonary complications include neurological, nephrological, ocular, and oral complications.
Keywords: Coronavirus disease; Covid-19; Critically ill; FTTL, Full Thickness Tracheal Lesions; IMV, Invasive Mechanical Ventilation; Intensive care unit; Invasive mechanical ventilation; LPV, Lung Protective Ventilation; SAPS 2, Simplified Acute Physiology Score 2; SOFA, Sequential Organ Failure Assessment score; TEF, Tracheoesophageal fistula; VAP, Ventilator Associated Pneumonia.
© 2022 The Author(s).