Viola Lorenzo, Russo Emanuele, Benni Marco, Gamberini Emiliano, Circelli Alessandro, Bissoni Luca, Santonastaso Domenico Pietro, Scognamiglio Giovanni, Bolondi Giuliano, Mezzatesta Luca, Agnoletti Vanni
U.O. Anestesia e Rianimazione, Ospedale "M. Bufalini" Hospital, 286, Viale Ghirotti, Cesena, Italy.
University of Messina, Messina, Italy.
Transl Med Commun. 2020;5(1):27. doi: 10.1186/s41231-020-00076-9. Epub 2020 Dec 21.
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.
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.
Both respiratory system and transpulmonary compliance and driving pressure confirmed the pseudo-normal respiratory mechanics of early CoVID-19 pneumonia (respectively, C 40.8 ml/cmHO and DP 9.7 cmHO; C 53.1 ml/cmHO and DP 7.9 cmHO). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (C 56.3 ml/cmHO and C 41.5 ml/cmHO - P 0.37; C 80.8 ml/cmHO and C 53.2 ml/cmHO - P 0.23).
Despite the severe ARDS pattern, respiratory system and lung mechanical properties during CoVID-19 pneumonia are pseudo-normal and tend to worsen during pronation.
Restrospectively registered.
本研究旨在提供关于新型冠状病毒肺炎（COVID-19）早期阶段肺力学的系统数据，并探索其在俯卧位期间的变化情况。
我们招募了4名在意大利切塞纳市“M. Bufalini”医院重症监护病房住院的患者；在放置食管球囊后，我们每6小时测量一次机械功率、呼吸系统和跨肺参数以及动脉血气，分别在体位改变前和俯卧-仰卧位转换后1小时进行测量。
呼吸系统和跨肺顺应性以及驱动压力均证实了COVID-19肺炎早期的假正常呼吸力学（分别为C 40.8 ml/cmH₂O和DP 9.7 cmH₂O；C 53.1 ml/cmH₂O和DP 7.9 cmH₂O）。有趣的是，俯卧位随着时间推移会导致呼吸力学特性恶化（C 56.3 ml/cmH₂O和C 41.5 ml/cmH₂O - P 0.37；C 80.8 ml/cmH₂O和C 53.2 ml/cmH₂O - P 0.23）。
尽管存在严重的急性呼吸窘迫综合征（ARDS）模式，但COVID-19肺炎期间的呼吸系统和肺力学特性为假正常，且在俯卧位时趋于恶化。
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