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. 2020;5(1):27.
doi: 10.1186/s41231-020-00076-9. Epub 2020 Dec 21.

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

Lorenzo Viola  1 , Emanuele Russo  1 , Marco Benni  1 , Emiliano Gamberini  1 , Alessandro Circelli  1 , Luca Bissoni  1 , Domenico Pietro Santonastaso  1 , Giovanni Scognamiglio  1 , Giuliano Bolondi  1 , Luca Mezzatesta  1   2 , Vanni Agnoletti  1
Affiliations

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

Lorenzo Viola et al. Transl Med Commun. 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, CRS 40.8 ml/cmH2O and DPRS 9.7 cmH2O; CL 53.1 ml/cmH2O and DPL 7.9 cmH2O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (CRS,SUP 56.3 ml/cmH2O and CRS,PR 41.5 ml/cmH2O - P 0.37; CL,SUP 80.8 ml/cmH2O and CL,PR 53.2 ml/cmH2O - 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.

Keywords: CoVID-19 pneumonia; mechanical power.; prone positioning; transpulmonary pressure.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Mechanical and Ventilation/Perfusion ratio variations in supine and prone positioning, just before decubitus change. CRS: Respiratory System Compliance; CL: Transpulmonary Compliance; A-aO2 gradient: alveolar-to-arterial oxygen gradient; EtCO2/paCO2 ratio: end-tidal CO2 to paCO2 ratio
See this image and copyright information in PMC

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