ABSTRACT
A patient regularly self-performing home oscillometry developed severe COVID-19 pneumonia and continued testing during and after the disease. COVID-19 suddenly worsened oscillatory reactance, which took almost 1 year to recover to pre-COVID-19 values. https://bit.ly/3WCpWC0.
ABSTRACT
In November 2020, Europe faced the second Covid-19 pandemic wave. The need to manage patients while reducing potential exposure and healthcare system overload led to renewed interest in home-monitoring of respiratory variables. Together with variables related to COVID-19 infection [1], home-based lung imaging [2] and lung mechanics [3, 4] were used to monitor COVID-19 and chronic respiratory patients during limited access to traditional care. Home monitoring respiratory-specific variables may provide important information about patient health status and clinical course.
ABSTRACT
BACKGROUND: Non-invasive ventilation (NIV) has been increasingly used in COVID-19 patients. The limited physiological monitoring and the unavailability of respiratory mechanic measures, usually obtainable during invasive ventilation, is a limitation of NIV for ARDS and COVID-19 patients management. OBJECTIVES: This pilot study was aimed to evaluate the feasibility of non-invasively monitoring respiratory mechanics by oscillometry in COVID-19 patients with moderate-severe acute respiratory distress syndrome (ARDS) receiving NIV. METHOD: 15 COVID-19 patients affected by moderate-severe ARDS at the RICU (Respiratory Intensive Care Unit) of the University hospital of Cattinara, Trieste, Italy were recruited. Patients underwent oscillometry tests during short periods of spontaneous breathing between NIV sessions. RESULTS: Oscillometry proved to be feasible, reproducible and well-tolerated by patients. At admission, 8 of the 15 patients showed oscillometry parameters within the normal range which further slightly improved before discharge. At discharge, four patients had still abnormal respiratory mechanics, not exclusively linked to pre-existing respiratory comorbidities. Lung mechanics parameters were not correlated with oxygenation. CONCLUSIONS: Our results suggest that lung mechanics provide complementary information for improving patients phenotyping and personalisation of treatments during NIV in COVID 19 patients, especially in the presence of respiratory comorbidities where deterioration of lung mechanics may be less coupled with changes in oxygenation and more difficult to identify. Oscillometry may provide a valuable tool for monitoring lung mechanics in COVID 19 patients receiving NIV.