ABSTRACT
BACKGROUND: During the COVID-19 outbreak, a very high number of infected patients developed pneumonia and many of them complicated with acute respiratory distress syndrome. The optimal management of respiratory failure and the role of lung ultrasound imaging in the evaluation of efficacy of treatment are unknown. METHODS: In March 2020 we treated 18 patients with mild and moderate ARDS secondary to SARS-CoV-2 with non-invasive continuous positive airway pressure therapy (NI-CPAP). All patients underwent lung ultrasound imaging to verify the entity of lung recruitment after NI-CPAP initiation. RESULTS: After one hour of treatment we observed a significant improvement in PaO2/FiO2 ratio in 10 patients. Notably, only 50 % of them reached an effective improvement in lung aeration detectable with lung ultrasound. In the other 50 % or patients the improvement in PaO2/FiO2 might be related to blood redistribution and reverse of hypoxic vasoconstriction. CONCLUSION: NI- CPAP is a valid therapeutic option in mild and moderate ARDS secondary SARS-CoV-2. Lung recruitment detected by means of lung ultrasound is a relevant but not the exclusive mechanism that underlies the therapeutic efficacy of NI-CPAP in this clinical setting.
Subject(s)
Betacoronavirus , Continuous Positive Airway Pressure/methods , Coronavirus Infections/complications , Coronavirus Infections/therapy , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/diagnostic imaging , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Prospective Studies , Respiratory Distress Syndrome/diagnostic imaging , SARS-CoV-2ABSTRACT
OBJECTIVE: The aim of this study is to determine the effectiveness of using a leg support exoskeleton (legX) in different modes on simulated work tasks which emulate real-world job tasks. BACKGROUND: Prolonged kneeling and squatting tasks increase the risk of work-related musculoskeletal disorders at the knee in industrial occupations. METHODS: We evaluated legX capable of spring assistance throughout one's range of motion and/or locking support at a fixed angular position. Participants performed a dynamic panel task, alternating between hip and knee height, and a sustained floor level task with and without the exoskeleton. The exoskeleton was evaluated in spring mode, locking mode, and spring + locking mode for the panel task and only in locking mode for the floor task. The participants' (N = 15) muscle activity was recorded for the right lumbar erector spinae, thoracic erector spinae, tibialis anterior, rectus femoris, semitendinosus, and lateral gastrocnemius. RESULTS: Significant reduction of the rectus femoris activity was observed with the exoskeleton (median reduction: 22%-56% and peak reduction: 12%-48% for the panel task and median reduction: 57% and peak reduction:34% during the floor task). CONCLUSION: legX significantly reduces rectus femoris activity during squatted static (floor) and dynamic (panel) work and may reduce pain and discomfort associated with squatting and potentially reduce the risk of developing knee disorders. Dynamic tasks benefit from both locking modes and spring assistance, the greatest benefit occurring with a combination of the two. APPLICATION: These results show that the legX can be beneficial to activities such as electrical panel work, grinding, sanding of larger surfaces, and concrete laying.
