10/4/2023 0 Comments V/q shunt vs dead spaceProne positioning decreased dead space fraction in 12 patients, decreased shunt fraction in 11 and decreased both shunt and dead space in 9. Eight out of 14 patients had increased PaO 2/FiO 2 from SP1 to SP2. Prone positioning improved V/Q matching and PaO 2/FiO 2 in all the patients. V/Q matching, dead space fraction and oxygenation improved at PP, but were not maintained 1 h after resupination (Fig. To quantify the relative contribution of the dead space versus shunt fraction to V/Q mismatch, we calculated the dead space-to-shunt ratio.įourteen patients with bilateral pneumonia were enrolled (Additional file 1: Table S1). Pixels were denoted as shunt if they were identified as perfused but not ventilated. Pixels were denoted as dead space if they were identified as ventilated but not perfused. V/Q matching was quantified as percentage of pixels classified as ventilated divided by the number of pixels classified as perfused. Clinical data collection, end expiratory occlusion and injection were repeated 1 h after resupination (time-point SP2).įrom offline analyses of EIT data obtained 5 min before and during saline bolus injection, we calculated V/Q matching as described previously. Inclusion criteria were: age > 18 and ≤ 75 years, admitted to ICU with confirmed COVID-19-related pneumonia, receiving supplemental oxygen (standard oxygen therapy or high-flow nasal cannula (HFNC)) for 3 h (ranged from 3 to 5.8 h without interruption) before being returned to the supine position. In this study, we assessed the effect of prone position on V/Q matching using electrical impedance tomography (EIT) in non-intubated COVID-19 patients. Whether awake prone positioning can improve ventilation/perfusion (V/Q) matching through redistribution of pulmonary perfusion has not been demonstrated. In the early phase of COVID-19, hypoxemia may be caused by impaired regulation of pulmonary perfusion. It is also a mainstay of treatment in COVID-19-related ARDS (C-ARDS) and reduces the need for intubation without any signal of harm. Prone positioning may recruit gas exchange-efficient regions for typical acute respiratory distress syndrome (ARDS) and improve oxygenation.
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