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. 2024 Jan 24;69(2):222-226.
doi: 10.4187/respcare.11175.

Ventilation Distribution During Changes in Trunk Inclination in Patients With ARDS

Francesco Marrazzo  1 , Stefano Spina  1 , Francesco Zadek  2 , Clarissa Forlini  1 , Gabriele Bassi  1 , Riccardo Giudici  1 , Giacomo Bellani  2   3 , Roberto Fumagalli  1   2 , Thomas Langer  4   2
Affiliations

Ventilation Distribution During Changes in Trunk Inclination in Patients With ARDS

Francesco Marrazzo et al. Respir Care. .
No abstract available

Keywords: Acute Respiratory Distress Syndrome; COVID-19; Mechanical Ventilation; Ventilator-Induced Lung Injury; trunk inclination.

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Conflict of interest statement

The authors have disclosed no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Example of the effects of the different trunk inclinations on end-expiratory lung impedance (EELI), ventilation redistribution, and regional compliance in one subject with COVID-19 ARDS who was mechanically ventilated. The subject was studied in 3 consecutive steps: (1) semi-recumbent with head-of-the-bed at 40°, (2) supine-flat at 0°, and (3) semi-recumbent with head-of-the-bed at 40°. Step 1 was used as a reference. The supine-flat position (at constant ventilatory settings) was associated with a marked improvement of ventral compliance, which thus resulted in a ventilation redistribution toward the ventral, non-dependent region. Ventilation redistribution and regional compliance were assessed at the beginning of each step (blue marks). EELI increased over 15 min of observation in each of the 2 semi-recumbent steps, whereas it decreased over the 15-min observation in the supine-flat step, which suggests a loss of aeration in this position. EELI values are reported on the left y-axis. End-inspiratory pressure (EIP - red line) and Positive end-expiratory pressure (PEEP - yellow line) values are reported on the right y-axis.
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