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

• Main Authors: Lorenzo Viola, Emanuele Russo, Marco Benni, Emiliano Gamberini, Alessandro Circelli, Luca Bissoni, Domenico Pietro Santonastaso, Giovanni Scognamiglio, Giuliano Bolondi, Luca Mezzatesta, Vanni Agnoletti
• Format: Article
• Language: English
• Published: BMC 2020-12-01
• Series: Translational Medicine Communications
• Subjects: CoVID-19 pneumonia; transpulmonary pressure; prone positioning; mechanical power.
• Online Access: https://doi.org/10.1186/s41231-020-00076-9

Abstract 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, CRS 40.8 ml/cmH2O and DPRS 9.7 cmH2O; CL 53.1 ml/cmH2O and DPL 7.9 cmH2O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (CRS,SUP 56.3 ml/cmH2O and CRS,PR 41.5 ml/cmH2O – P 0.37; CL,SUP 80.8 ml/cmH2O and CL,PR 53.2 ml/cmH2O – 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.