Start Over

Lung mechanics in type L CoVID-19 pneumonia: a pseudo-normal ARDS.

Authors :: Viola L
Russo E
Benni M
Gamberini E
Circelli A
Bissoni L
Santonastaso DP
Scognamiglio G
Bolondi G
Mezzatesta L
Agnoletti V
Source :: Translational medicine communications [Transl Med Commun] 2020; Vol. 5 (1), pp. 27. Date of Electronic Publication: 2020 Dec 21.
Publication Year :: 2020
Abstract: Background: This study was conceived to provide systematic data about lung mechanics during early phases of CoVID-19 pneumonia, as long as to explore its variations during prone positioning. Methods: We enrolled four patients hospitalized in the Intensive Care Unit of "M. Bufalini" hospital, Cesena (Italy); after the positioning of an esophageal balloon, we measured mechanical power, respiratory system and transpulmonary parameters and arterial blood gases every 6 hours, just before decubitus change and 1 hour after prono-supination. Results: Both respiratory system and transpulmonary compliance and driving pressure confirmed the pseudo-normal respiratory mechanics of early CoVID-19 pneumonia (respectively, C <subscript>RS</subscript> 40.8 ml/cmH <subscript>2</subscript> O and DP <subscript>RS</subscript> 9.7 cmH <subscript>2</subscript> O; C <subscript>L</subscript> 53.1 ml/cmH <subscript>2</subscript> O and DP <subscript>L</subscript> 7.9 cmH <subscript>2</subscript> O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (C <subscript>RS,SUP</subscript> 56.3 ml/cmH <subscript>2</subscript> O and C <subscript>RS,PR</subscript> 41.5 ml/cmH <subscript>2</subscript> O - P 0.37; C <subscript>L,SUP</subscript> 80.8 ml/cmH <subscript>2</subscript> O and C <subscript>L,PR</subscript> 53.2 ml/cmH <subscript>2</subscript> O - P 0.23). Conclusions: Despite the severe ARDS pattern, respiratory system and lung mechanical properties during CoVID-19 pneumonia are pseudo-normal and tend to worsen during pronation. Trial Registration: Restrospectively registered. Competing Interests: Competing interestsThe authors declare that they have no competing interests. (© The Author(s) 2020.)