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1.
BMC Pulm Med ; 21(1): 38, 2021 Jan 22.
Article in English | MEDLINE | ID: covidwho-1044906

ABSTRACT

BACKGROUND: Clinical management of COVID-19 requires close monitoring of lung function. While computed tomography (CT) offers ideal way to identify the phenotypes, it cannot monitor the patient response to therapeutic interventions. We present a case of ventilation management for a COVID-19 patient where electrical impedance tomography (EIT) was used to personalize care. CASE PRESENTATION: The patient developed acute respiratory distress syndrome, required invasive mechanical ventilation, and was subsequently weaned. EIT was used multiple times: to titrate the positive end-expiratory pressure, understand the influence of body position, and guide the support levels during weaning and after extubation. We show how EIT provides bedside monitoring of the patient´s response to various therapeutic interventions and helps guide treatments. CONCLUSION: EIT provides unique information that may help the ventilation management in the pandemic of COVID-19.


Subject(s)
/diagnostic imaging , Electric Impedance , Lung/diagnostic imaging , Patient Positioning/methods , Respiration, Artificial/methods , Tomography/methods , /physiopathology , Humans , Male , Middle Aged , Positive-Pressure Respiration/methods , /therapy , Ventilator Weaning/methods
3.
Semin Cardiothorac Vasc Anesth ; 24(4): 287-292, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-760476

ABSTRACT

At the end of 2019, a novel coronavirus (COVID-19) was identified as the cause of a cluster of pneumonia cases, with high needs of mechanical ventilation in critically ill patients. It is still unclear whether different types of COVID-19 pneumonia require different ventilator strategies. With electrical impedance tomography (EIT) we evaluated, in real time and bedside, the distribution of ventilation in the different pulmonary regions before, during, and after pronation in COVID-19 respiratory failure. We present a brief literature review of EIT in non-COVID-19 patients and a report of 2 COVID-19 patients: one that did not respond well and another one that improved during and after pronation. EIT might be a useful tool to decide whether prone positioning should or should not be used in COVID-19 pneumonia.


Subject(s)
Coronavirus Infections/diagnostic imaging , Coronavirus Infections/therapy , Electric Impedance , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/therapy , Respiration, Artificial/methods , Tomography/methods , Aged , Betacoronavirus , Fatal Outcome , Humans , Male , Pandemics , Prone Position
6.
Physiol Meas ; 41(8): 085008, 2020 09 10.
Article in English | MEDLINE | ID: covidwho-690496

ABSTRACT

OBJECTIVE: Patients with the novel coronavirus disease (COVID-19) often have airway secretions that severely compromise ventilation. This study investigates electrical impedance tomography (EIT) monitoring of a therapeutic bronchoalveolar lavage (BAL) in a patient with COVID-19. APPROACH: A patient with COVID-19 developed acute respiratory distress syndrome requiring mechanical ventilation. He received regional BAL to remove mucus in the small airways (20 ml × 5). Regional ventilation changes before BAL, 30 min after and in the following days, were monitored with EIT. MAIN RESULTS: Regional ventilation worsened shortly after BAL and improved in the following days. The improvement of the oxygenation did not exactly match the ventilation improvement, which indicated a possible ventilation/perfusion mismatch. SIGNIFICANCE: Therapeutic BAL might improve regional ventilation for COVID-19 and EIT could be a useful tool at the bedside to monitor the ventilation treatment of COVID-19.


Subject(s)
Betacoronavirus , Bronchoalveolar Lavage/methods , Coronavirus Infections/therapy , Electric Impedance/therapeutic use , Monitoring, Physiologic/methods , Pneumonia, Viral/therapy , Respiration, Artificial/methods , Aged , Coronavirus Infections/complications , Coronavirus Infections/diagnostic imaging , Humans , Male , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , /etiology , Tomography/methods
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