scholarly journals Lung ultrasound monitoring of CPAP effectiveness on SARS-CoV-2 pneumonia: A case report

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Marco Montanari ◽  
Pierpaolo De Ciantis ◽  
Andrea Boccatonda ◽  
Marta Venturi ◽  
Giuseppe D'Antuono ◽  
...  
Keyword(s):  
Pressure Support ◽  
Lung Ultrasound ◽  
High Peep ◽  
Imaging Method ◽  
Non Invasive ◽  
Ultrasound Monitoring ◽  
Air Interface ◽  
Non Invasive Ventilation ◽  
Heterogeneous Features ◽  
Risk Of Exposure

SARS-CoV-2 infection is characterized by extremely heterogeneous features, going from cases with few symptoms to severe respiratory failures. Chest Computed Tomography (CT) is currently the gold-standard imaging method, although burdened by the risk of exposure to ionizing radiation and management / organizational concerns. In particular, the critical patient undergoing ventilation (invasive or not) seems to be difficult to monitor by repeated CT scan over time. We report the case of a 55-year-old male patient subjected to Continuous Positive Airway Pressure (CPAP) and prone positioning, in which the use of ultrasound monitoring allowed to verify the effectiveness of the pressure support used in recruiting previously atelectasis lung areas. Lung ultrasound can guide pulmonary recruitment and pronation maneuvers in patients undergoing non-invasive ventilation. Ultrasound can identify atelectatic lung areas, which demonstrate an alveolar re-expansion following the setting of high PEEP values, as underlined by the reappearance of pleural/air interface.

Non-invasive ventilation

2021 ◽  
pp. 267-283
Author(s):  
Josep Masip ◽  
Kenneth Planas ◽  
Arantxa Mas
Keyword(s):  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Hospital Setting ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Support Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, immunocompromised or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure, bilevel pressure support ventilation and more recently, high flow nasal cannula. Whereas non-invasive pressure support ventilation requires a ventilator, the other two techniques are simpler and can be easily used in non-equipped areas by less experienced teams, including the pre-hospital setting. The success of non-invasive ventilation is related to an adequate timing, proper selection of patients and interfaces, close monitoring as well as the achievement of a good adaptation to patients’ demand.

Non-invasive ventilation

2017 ◽  
Author(s):  
Josep Masip ◽  
Kenneth Planas ◽  
Arantxa Mas
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Pressure Support Ventilation ◽  
Airway Pressure ◽  
Pressure Support ◽  
Positive Airway Pressure ◽  
Fine Tuning ◽  
Invasive Ventilation ◽  
Support Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.

scholarly journals Lung ultrasound reaeration score: a useful tool to predict non-invasive ventilation effectiveness

Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P255 ◽  
Author(s):  
L Nobile ◽  
P Beccaria ◽  
M Zambon ◽  
L Cabrini ◽  
G Landoni ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Ventilation Effectiveness

scholarly journals Lung ultrasound as a predictor of mortality of patients with COVID-19

2021 ◽  
pp. e20210092
Author(s):  
Fernando A. Sosa1 ◽  
Agustín Matarrese1 ◽  
Santiago Saavedra1 ◽  
Javier Osatnik1 ◽  
Javier Roberti2 ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Lung Ultrasound ◽  
Area Under The Curve ◽  
Invasive Ventilation ◽  
High Flow Nasal Cannula ◽  
Short Term ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Reproducible Method ◽  
Score Range

Objective: To evaluate the performance of lung ultrasound to determine short-term outcomes of patients with COVID-19 admitted to the intensive care unit. Methods: This is a Prospective, observational study. Between July and November 2020, 59 patients were included and underwent at least two LUS assessments using LUS score (range 0-42) on day of admission, day 5th, and 10th of admission. Results: Age was 66.5±15 years, APACHE II was 8.3±3.9, 12 (20%) patients had malignancy, 46 (78%) patients had a non-invasive ventilation/high-flow nasal cannula and 38 (64%) patients required mechanical ventilation. The median stay in ICU was 12 days (IQR 8.5-20.5 days). ICU or hospital mortality was 54%. On admission, the LUS score was 20.8±6.1; on day 5th and day 10th of admission, scores were 27.6±5.5 and 29.4±5.3, respectively (P=0.007). As clinical condition deteriorated the LUS score increased, with a positive correlation of 0.52, P <0.001. Patients with worse LUS on day 5th versus better score had a mortality of 76% versus 33% (OR 6.29, 95%CI 2.01-19.65, p. 0.003); a similar difference was observed on day 10. LUS score of 5th day of admission had an area under the curve of 0.80, best cut-point of 27, sensitivity and specificity of 0.75 and 0.78 respectively. Conclusion: These findings position LUS as a simple and reproducible method to predict the course of COVID-19 patients.

Sign in / Sign up

Export Citation Format

Share Document