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Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography
BACKGROUND: Gravity‐dependent positioning therapy is an established concept in the treatment of severe acute respiratory distress syndrome and improves oxygenation in spontaneously breathing patients with hypoxemic acute respiratory failure. In patients with coronavirus disease 2019, this therapy se...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874544/ https://www.ncbi.nlm.nih.gov/pubmed/36268561 http://dx.doi.org/10.1111/aas.14161 |
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author | Zitzmann, Amelie Pulletz, Sven Gonzales‐Rios, Pablo Frenkel, Paul Teschendorf, Peter Kremeier, Peter Löser, Benjamin Krukewitt, Lisa Reuter, Daniel A. Böhm, Stephan H. Müller‐Graf, Fabian |
author_facet | Zitzmann, Amelie Pulletz, Sven Gonzales‐Rios, Pablo Frenkel, Paul Teschendorf, Peter Kremeier, Peter Löser, Benjamin Krukewitt, Lisa Reuter, Daniel A. Böhm, Stephan H. Müller‐Graf, Fabian |
author_sort | Zitzmann, Amelie |
collection | PubMed |
description | BACKGROUND: Gravity‐dependent positioning therapy is an established concept in the treatment of severe acute respiratory distress syndrome and improves oxygenation in spontaneously breathing patients with hypoxemic acute respiratory failure. In patients with coronavirus disease 2019, this therapy seems to be less effective. Electrical impedance tomography as a point‐of‐care functional imaging modality for visualizing regional ventilation can possibly help identify patients who might benefit from positioning therapy and guide those maneuvers in real‐time. Therefore, in this prospective observational study, we aimed to discover typical patterns in response to positioning maneuvers. METHODS: Distribution of ventilation in 10 healthy volunteers and in 12 patients with hypoxemic respiratory failure due to coronavirus disease 2019 was measured in supine, left, and right lateral positions using electrical impedance tomography. RESULTS: In this study, patients with coronavirus disease 2019 showed a variety of ventilation patterns, which were not predictable, whereas all but one healthy volunteer showed a typical and expected gravity‐dependent distribution of ventilation with the body positions. CONCLUSION: Distribution of ventilation and response to lateral positioning is variable and thus unpredictable in spontaneously breathing patients with coronavirus disease 2019. Electrical impedance tomography might add useful information on the immediate reaction to postural maneuvers and should be elucidated further in clinical studies. Therefore, we suggest a customized individualized positioning therapy guided by electrical impedance tomography. |
format | Online Article Text |
id | pubmed-9874544 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98745442023-01-25 Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography Zitzmann, Amelie Pulletz, Sven Gonzales‐Rios, Pablo Frenkel, Paul Teschendorf, Peter Kremeier, Peter Löser, Benjamin Krukewitt, Lisa Reuter, Daniel A. Böhm, Stephan H. Müller‐Graf, Fabian Acta Anaesthesiol Scand Intensive Care and Physiology BACKGROUND: Gravity‐dependent positioning therapy is an established concept in the treatment of severe acute respiratory distress syndrome and improves oxygenation in spontaneously breathing patients with hypoxemic acute respiratory failure. In patients with coronavirus disease 2019, this therapy seems to be less effective. Electrical impedance tomography as a point‐of‐care functional imaging modality for visualizing regional ventilation can possibly help identify patients who might benefit from positioning therapy and guide those maneuvers in real‐time. Therefore, in this prospective observational study, we aimed to discover typical patterns in response to positioning maneuvers. METHODS: Distribution of ventilation in 10 healthy volunteers and in 12 patients with hypoxemic respiratory failure due to coronavirus disease 2019 was measured in supine, left, and right lateral positions using electrical impedance tomography. RESULTS: In this study, patients with coronavirus disease 2019 showed a variety of ventilation patterns, which were not predictable, whereas all but one healthy volunteer showed a typical and expected gravity‐dependent distribution of ventilation with the body positions. CONCLUSION: Distribution of ventilation and response to lateral positioning is variable and thus unpredictable in spontaneously breathing patients with coronavirus disease 2019. Electrical impedance tomography might add useful information on the immediate reaction to postural maneuvers and should be elucidated further in clinical studies. Therefore, we suggest a customized individualized positioning therapy guided by electrical impedance tomography. John Wiley and Sons Inc. 2022-11-03 2023-02 /pmc/articles/PMC9874544/ /pubmed/36268561 http://dx.doi.org/10.1111/aas.14161 Text en © 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Intensive Care and Physiology Zitzmann, Amelie Pulletz, Sven Gonzales‐Rios, Pablo Frenkel, Paul Teschendorf, Peter Kremeier, Peter Löser, Benjamin Krukewitt, Lisa Reuter, Daniel A. Böhm, Stephan H. Müller‐Graf, Fabian Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title | Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title_full | Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title_fullStr | Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title_full_unstemmed | Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title_short | Regional ventilation in spontaneously breathing COVID‐19 patients during postural maneuvers assessed by electrical impedance tomography |
title_sort | regional ventilation in spontaneously breathing covid‐19 patients during postural maneuvers assessed by electrical impedance tomography |
topic | Intensive Care and Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874544/ https://www.ncbi.nlm.nih.gov/pubmed/36268561 http://dx.doi.org/10.1111/aas.14161 |
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