Finally, we cannot exclude the possibility that next to mechanical ventilation, the procedures related to the instrumentation/ventilation (e.g. intubation, arterial cannulation) also induce inflammation to a certain extent.
The severity of illness was ascertained through information on the use of continuous invasive mechanical ventilation (any procedures) or admission, discharge, or transition to the intensive care unit in the same admission.
The SARS virus, which is distantly related to MERS, is known to have spread widely in 2003 when tubes were placed in patients' airways for mechanical ventilation, a procedure that can cause the virus to become aerosolized.
We noted any surgical procedure, mechanical ventilation, and invasive procedure that took place 1 month before the patient's inclusion in the study.
Spontaneous pneumomediastinum can be distinguished from pneumomediastinum secondary to traumatic events, such as chest trauma or thoracic surgery, endobronchial or oesophageal procedures, mechanical ventilation or other invasive procedures [ 13].
ARDS patients require intubation and mechanical ventilation as lifesaving procedures, and positive end-expiratory pressure (PEEP) is a key element of mechanical ventilation settings.
In order to guarantee adequate safety and aerosol therapy efficiency during mechanical ventilation, standard operating procedures should be implemented including a checklist for physicians and nurses [34, 72].
It mainly results from direct chest trauma, barotrauma following mechanical ventilation and invasive procedures.
Infections related to prolonged mechanical ventilation and invasive procedures were the most frequent events noticed in this study.
Several of these patients required intubation, mechanical ventilation or urgent procedures (for example chest decompression, volume resuscitation or surgery).
