Effects of pron-position maneuver on some respiratory parameters in patients with pneumonia caused by the SARS-COV-2 VIRUS
https://doi.org/10.52485/19986173_2021_1_74
Abstract
The aim of the research. To assess the effect of the pron-position maneuver in patients with COVID-19 on the state of the respiratory system.
Materials and methods. The study was performed in 20 patients of both sexes, who developed bilateral community-acquired polysegmental viral-bacterial pneumonia against the background of COVID-19. All patients had background and concomitant pathology: coronary artery disease, diabetes mellitus, alimentary-constitutional obesity. X-ray picture of the lesion with computed tomography - at least 75% of the pulmonary fields. Patients received invasive respiratory support with a ventilator. A total of 8 parameters were investigated: General PEEP (Positive end expiratory pressure), Auto-PEEP (Positive end expiratory pressure), Сdyn (Dynamic Compliance), Cst (Static Compliance), RE (Expiratory Resistance), DO (tidal volume), Total expiratory volume, Residual volume. The study of the state of the respiratory system was carried out using the Neumovent GraphNet Advance ventilator.
Results. When assessing the group of indicators of the respiratory system, a regular decrease in Cst was revealed in patients on invasive mechanical ventilation by 14.7% at p = 0.028. There were no other changes in the parameters.
Conclusion. It was found that when performing a pron-position maneuver in patients with a severe course of COVID-19 who are on invasive mechanical ventilation, static compliance decreased by 14.7%. The tidal volume, Auto-PEEP, dead space and total tidal volume are independent of the pron-position maneuver, provided the patient is completely relaxed.
About the Authors
D. S. Shilin
City Clinical Hospital № 1 ; Chita State Medical Academy
Russian Federation
Russian Federation
8 Lenina str., Chita, 672010
39А Gorky str., Chita, 672000
F. R. Cheptsov
City Clinical Hospital № 1
Russian Federation
Russian Federation
8 Lenina str., Chita, 672010
J. S. Trusova
City Clinical Hospital № 1
Russian Federation
Russian Federation
8 Lenina str., Chita, 672010
V. A. Roslov
City Clinical Hospital № 1
Russian Federation
Russian Federation
8 Lenina str., Chita, 672010
K. G. Shapovalov
City Clinical Hospital № 1 ; Chita State Medical Academy
Russian Federation
Russian Federation
8 Lenina str., Chita, 672010
39А Gorky str., Chita, 672000
References
1. Coltart C.E.M., Lindsey B., Ghinai I., Johnson A.M., Heymann D.L., The Ebola outbreak, 2013- 2016: old lessons for new epidemics. Philos Trans R SocLond B Biol Sc. 2017. May 26. 372(1721). 20160297. doi: 10.1098/rstb.2016.0297.
2. Burkardt H.-J., Pandemic H1N1 2009 ('swine flu'): diagnostic and other challenges. Expert Rev MolDiagn. 2011. 11(1). 35-40. doi: 10.1586/erm.10.102.
3. Стопкоронавирус.рф — The official Internet resource for informing the population about the coronavirus (COVID-19). in Russian.
4. MalinnikovaE.Yu. New coronavirus infection. Today's look at the pandemic of the XXI century. Infektsionnyebolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (2): 18–32. DOI: 10.33029/2305-3496-2020-9-2-18-32 in Russian.
5. Shi H., Han X., Jiang N., et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020. 20 (4). 425-34.
6. McFadyenJ.D., StevensH., Karlheinz P., The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications. Circ Res & 2020. Jul 31. 127(4). 571-587. doi: 10.1161/CIRCRESAHA.120.317447. Epub 2020 Jun 26.
7. Bates J.H.T., Smith B. J. Ventilator-induced lung injury and lung mechanics Ann Transl Med. 2018. 6(19). 378. doi: 10.21037/atm.2018.06.29.
8. Temporary guidelines "Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)" Version 7 (approved by the Ministry of health of the Russian Federation on June 3, 2020). Ministry of health of the Russian Federation: [website]. 2020. URL: https://static0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_%D0%9CR_COVID-19_v7.pdf (accessed 22.06.2020). in Russian.
9. Rossi A., Gottfried S.B., Zocchi L., et al. Measurement of static compliance of the total respiratory system in patients with acute respiratory failure during mechanical ventilation. The effect of intrinsic positive end-expiratory pressure. Am Rev Respir Dis. 1985. 131. 672-677.
10. Arnal J.-М, Garnero A., Saoli M., Chatburn R.L. Parameters for Simulation of Adult Subjects During Mechanical Ventilation. Respir Care. 2018. 63(2). 158-168. doi: 10.4187/respcare.05775. Epub 2017 Oct 17.
11. Mughal M.M., Culver D.A., Minai O.A., Arroliga A.C. Auto-positive end-expiratory pressure: mechanisms and treatment. Cleve Clin J Med. 2005. 72(9). 801-9.
12. Marini J.J., Rocco P.R.M., Gattinoni L., Static and Dynamic Contributors to Ventilator-induced Lung Injury in Clinical Practice. Pressure, Energy, and Power. Am J RespirCrit Care Me . 2020. Apr 1. 201(7). 767-774. doi: 10.1164/rccm.201908-1545CI.
13. Pepe P.E., Marini J.J. Occult positive end-expiratory pressure in mechani- cally ventilated patients with airflow obstruction: the auto-PEEP effect. Am Rev Respir Dis. 1982. 126. 166-170
14. Brochard L., Slutsky A., Pesenti A. Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure. Am J RespirCrit Care Med. 2017. 195. 438-42.
15. Beloncle F.M., Pavlovsky B., Desprez C., Fage N., Olivier P.-Y., Asfar P., Richard J.-C., Mercat A., Recruitability and effect of PEEP in SARS-Cov-2-associated acute respiratory distress syndrome Ann Intensive Care. 2020. May 12. 10(1). 55. doi: 10.1186/s13613-020-00675-7.
16. Grasso S., Mirabella L., Murgolo F., Mussi R.D., Pisani L., Dalfino L., Spadaro S., Rauseo M., Lamanna A., Cinnella G., Effects of Positive End-Expiratory Pressure in "High Compliance" Severe Acute Respiratory Syndrome Coronavirus 2 Acute Respiratory Distress Syndrome. Crit Care Med. 2020 Dec. 48(12). e1332-e1336. doi: 10.1097/CCM.0000000000004640.
17. Mauri T., Spinelli E., Scotti E., Colussi G., Basile M.C., Crotti S., Tubiolo D., Tagliabue P., Zanella A., Grasselli G., Pesenti A., Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019. Crit Care Med. 2020. 48(8). 1129-1134. doi: 10.1097/CCM.0000000000004386.
18. Pan C., Chen L., Lu C., Zhang W., Xia J.-A., Sklar M.C., Du B., Brochard L., Qiu H., Lung Recruitability in COVID-19-associated Acute Respiratory Distress Syndrome: A Single-Center Observational Study. Am J RespirCrit Care Med. 2020. May 15. 201(10). 1294-1297. doi: 10.1164/rccm.202003-0527LE.
19. Marini J.J., Rocco P.R.M., Gattinoni L. Static and Dynamic Contributors to Ventilator-induced Lung Injury in Clinical Practice. Pressure, Energy, and Power. Am J RespirCrit Care Med. 2020. Apr 1. 201(7). 767-774. PMID: 31665612 PMCID: PMC7124710 DOI: 10.1164/rccm.201908-1545CI.
Review
For citations:
Shilin D.S., Cheptsov F.R., Trusova J.S., Roslov V.A., Shapovalov K.G. Effects of pron-position maneuver on some respiratory parameters in patients with pneumonia caused by the SARS-COV-2 VIRUS. Transbaikalian Medical Bulletin. 2021;(1):74-80. (In Russ.) https://doi.org/10.52485/19986173_2021_1_74
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