Lung mechanics in type L CoVID-19 pneumonia: a pseudo-normal ARDS

BACKGROUND: 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. METHODS: 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. RESULTS: Both respiratory system and transpulmonary compliance and driving pressure confirmed the pseudo-normal respiratory mechanics of early CoVID-19 pneumonia (respectively, C(RS) 40.8 ml/cmH(2)O and DP(RS) 9.7 cmH(2)O; C(L) 53.1 ml/cmH(2)O and DP(L) 7.9 cmH(2)O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (C(RS,SUP) 56.3 ml/cmH(2)O and C(RS,PR) 41.5 ml/cmH(2)O – P 0.37; C(L,SUP) 80.8 ml/cmH(2)O and C(L,PR) 53.2 ml/cmH(2)O – P 0.23). CONCLUSIONS: Despite the severe ARDS pattern, respiratory system and lung mechanical properties during CoVID-19 pneumonia are pseudo-normal and tend to worsen during pronation. TRIAL REGISTRATION: Restrospectively registered.