University of Campania "Luigi Vanvitelli".
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Acta Biomed. 2022 Jun 7;93(S1):e2022102. doi: 10.23750/abm.v93iS1.12824.
Platypnea-Orthodeoxia Syndrome (POS) is an often misdiagnosed clinical condition characterized by dyspnea and hypoxia in sitting or semi-sitting position, reversible in supine position. Although POS is typically associated with intracardiac shunts, it seems frequent also in SARS-CoV-2 related Acute Respiratory Distress Syndrome (ARDS). In fact, the prevalent involvement of the lung bases due to interstitial pneumonia can determine refractory positional hypoxemia, with marked desaturation in the sitting position and regression or improvement in the supine position, configuring the clinical picture of the POS. We present a clinical case of POS associated with acute respiratory distress from SARS-CoV-2 pneumonia in which refractory hypoxia would have required support by invasive mechanical ventilation if the syndrome had not been identified.
直立性呼吸困难-低氧血症综合征（POS）是一种常被误诊的临床病症，其特征是在坐或半坐位置时呼吸困难和缺氧，而在仰卧位置时可逆转。虽然 POS 通常与心内分流有关，但它似乎也经常发生在与 SARS-CoV-2 相关的急性呼吸窘迫综合征（ARDS）中。事实上，由于间质性肺炎，基底肺的普遍受累可导致难治性体位性低氧血症，在坐姿时出现明显的血氧饱和度下降，而在仰卧位时则恢复或改善，从而构成 POS 的临床特征。我们报告了一例与 SARS-CoV-2 肺炎相关的急性呼吸窘迫的 POS 临床病例，如果没有识别出该综合征，难治性缺氧可能需要通过有创机械通气来支持。
