Prone position in covid-19: Can we tackle rising dead space?

被引：4

作者：

Sharp, T. ^{[1
]}

Al-Faham, Z. ^{[1
]}

Brown, M. ^{[1
]}

Martin-Lazaro, J. ^{[1
]}

Morales, J. Cevallos ^{[1
]}

机构：

[1] Barts Hlth NHS Trust, London E1 1RD, England

来源：

JOURNAL OF THE INTENSIVE CARE SOCIETY | 2022年 / 23卷 / 02期

关键词：

COVID-19; ARDS; prone position; respiratory dead space; pulmonary ventilation;

D O I：

10.1177/1751143720975317

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Little is known about the impact of proning on oxygenation and ventilatory efficiency on patients with severe Covid-19. In this retrospective observational study we calculated Pa/FiO2 ratio (P/F) as a marker of oxygenation and dead space fraction (Vd/Vt) to assess ventilation. 12 patients who were proned twice or more were included. There was a significant improvement in P/F ratio when prone (110.18 +/- 28.11) compared to supine (88.95 +/- 19.34) (p<0.01). There was no improvement in Vd/Vt on proning (p>0.05). Vd/Vt as a function of time displayed a positive linear correlation in those who did not survive (n=9) (Rs=0.48, p<0.01) but no observed correlation in those who survived (n=3) (Rs=0.002, p=0.97). Our findings indicate that prone position in patients with Covid-19 has little effect on dead space fraction but does improve oxygenation. Rise in dead space with time appears to be a prognostic factor for death in patients with severe Covid- 19.

引用

页码：240 / 243

页数：4

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