Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 5;11(19):5885.
doi: 10.3390/jcm11195885.

Effects of a Chair Positioning Session on Awake Non-Intubated COVID-19 Pneumonia Patients: A Multicenter, Observational, and Pilot Study Using Lung Ultrasound

Alexandre Lopez  1 , Pierre Simeone  2   3 , Louis Delamarre  1 , Gary Duclos  1 , Charlotte Arbelot  1 , Ines Lakbar  1 , Bruno Pastene  1 , Karine Bezulier  1 , Samuel Dahan  1 , Emilie Joffredo  4 , Lucille Jay  4 , Lionel Velly  2   3 , Bernard Allaouchiche  4   5   6 , Sami Hraiech  7   8 , Marc Leone  1   9 , Laurent Zieleskiewicz  1   9
Affiliations

Effects of a Chair Positioning Session on Awake Non-Intubated COVID-19 Pneumonia Patients: A Multicenter, Observational, and Pilot Study Using Lung Ultrasound

Alexandre Lopez et al. J Clin Med. .

Abstract

Background: LUS is a validated tool for the management of COVID-19 pneumonia. Chair positioning (CP) may have beneficial effects on oxygenation and lung aeration, and may be an easier alternative to PP. This study assessed the effects of a CP session on oxygenation and lung aeration (LA) changes in non-intubated COVID-19 patients.

Methods: A retrospective multicenter study was conducted in an ICU. We analyzed data from LUS exams and SpO2:FiO2 performed before/after a CP session in non-intubated COVID-19 patients. Patients were divided into groups of responders or non-responders in terms of oxygenation or LA.

Results: Thirty-three patients were included in the study; fourteen (44%) were oxygenation non-responders and eighteen (56%) were oxygenation responders, while thirteen (40.6%) and nineteen (59.4%) patients were classified as LA non-responders and responders, respectively. Changes in oxygenation and LA before/after a CP session were not correlated (r = -0.19, p = 0.3, 95% CI: -0.5-0.17). The reaeration scores did not differ between oxygenation responders and non-responders (1 (-0.75-3.75) vs. 4 (-1-6), p = 0.41). The LUS score was significantly correlated with SpO2:FiO2 before a CP session (r = 0.37, p = 0.04, 95% CI: 0.03-0.64) but not after (r = 0.17, p = 0.35, 95% CI: -0.19-0.50).

Conclusion: A CP session was associated with improved oxygenation and LA in more than half of the non-intubated COVID-19 patients.

Keywords: COVID-19 pneumonia; acute respiratory failure; chair positioning; intensive care; lung ultrasound.

PubMed Disclaimer

Conflict of interest statement

L.Z. received fees from General Electric Healthcare for teaching ultrasound to General Electric Healthcare customers. The other authors do not have any link of interest related to this work.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Variations in the SpO2:FiO2 ration (a) and reaeration score (b) after the chair trial in the whole cohort.
Figure 3
Figure 3
Variations in the SpO2:FiO2 ratio and reaeration score before (a) and after (b) the CP session, and variation of oxygenation and reaeration after CP session (c) in the whole cohort.
See this image and copyright information in PMC

References

    1. Zieleskiewicz L., Markarian T., Lopez A., Taguet C., Mohammedi N., Boucekine M., Baumstarck K., Besch G., Mathon G., Duclos G., et al. Comparative study of lung ultrasound and chest computed tomography scan in the assessment of severity of confirmed COVID-19 pneumonia. Intensive Care Med. 2020;46:1707–1713. doi: 10.1007/s00134-020-06186-0. - DOI - PMC - PubMed
    1. Hussain A., Via G., Melniker L., Goffi A., Tavazzi G., Neri L., Villen T., Hoppmann R., Mojoli F., Noble V., et al. Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): International expert consensus. Crit. Care. 2020;24:702. doi: 10.1186/s13054-020-03369-5. - DOI - PMC - PubMed
    1. Aliaga M., Forel J.-M., De Bourmont S., Jung B., Thomas G., Mahul M., Bisbal M., Nougaret S., Hraiech S., Roch A., et al. Diagnostic yield and safety of CT scans in ICU. Intensive Care Med. 2015;41:436–443. doi: 10.1007/s00134-014-3592-1. - DOI - PubMed
    1. Buonsenso D., Pata D., Chiaretti A. COVID-19 outbreak: Less stethoscope, more ultrasound. Lancet Respir. Med. 2020;8:e27. doi: 10.1016/S2213-2600(20)30120-X. - DOI - PMC - PubMed
    1. Jia L., Wang H., Gao Y., Liu H., Yu K. High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: A prospective, multicenter study in China. Crit. Care. 2016;20:12. doi: 10.1186/s13054-016-1183-y. - DOI - PMC - PubMed

LinkOut - more resources