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Wu S, Zhang Y, Gao X, Lei X. Prudence required when implementing prone position ventilation in patients with severe thrombocytopenia. Asian J Surg 2024; 47:1913-1914. [PMID: 38185551 DOI: 10.1016/j.asjsur.2023.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/25/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Songlin Wu
- Department of Critical Care Medicine, The Affiliated Hospital, Southwest Medical University, China
| | - Yingying Zhang
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, China
| | - Xiaolan Gao
- Department of Critical Care Medicine, The Affiliated Hospital, Southwest Medical University, China
| | - Xianying Lei
- Department of Critical Care Medicine, The Affiliated Hospital, Southwest Medical University, China.
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Zhang Z, Wang C, Li Z, Liu Y, Nie Y, Zhang J, Li D. Efficacy of respiratory rehabilitation in patients with COVID-19: a retrospective study. BMC Pulm Med 2024; 24:152. [PMID: 38532376 DOI: 10.1186/s12890-024-02969-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has resulted in millions of confirmed cases and deaths globally. The purpose of this study was to investigate the therapeutic effect of airway clearance technology combined with prone ventilation on patients infected with COVID-19. METHODS 38 patients with COVID-19 (severe) who were treated in the intensive rehabilitation group of Shengli Oilfield Central Hospital. They were randomly divided into a control group and an observation group. The control group received prone position ventilation intervention, and the observation group received airway clearance technology combined with prone position ventilation intervention. The changes of oxygen and index, procalcitonin (PCT), interleukin-6 (IL-6) and chest X-ray image indexes were compared between the two groups. RESULT There was no significant difference in age, gender and other general data between the control group and the observation group. The results showed that oxygen index, PCT, IL-6 and chest X-ray image index in the observation group were better than that indexes in the control group. CONCLUSION Airway clearance technology combined with prone ventilation intervention in patients with COVID-19 can improve the total effective rate and oxygenation index, improve the inflammatory indicators and respiratory function of patients. And it may be widely promoted and used in the treatment of patients with COVID-19 (severe).
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Affiliation(s)
- Zhiyou Zhang
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Congcong Wang
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Zhendong Li
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Yueyang Liu
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Yutong Nie
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Jianwei Zhang
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China
| | - Dawei Li
- Department of Neurorehabilitation, Shengli Oilfield Central Hospital, No. 31 Jinan Road, 257000, Dongying, Shandong, China.
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Todur P, Nileshwar A, Chaudhuri S, Shanbhag V, Cherisma C. Changes in Driving Pressure vs Oxygenation as Predictor of Mortality in Moderate to Severe Acute Respiratory Distress Syndrome Patients Receiving Prone Position Ventilation. Indian J Crit Care Med 2024; 28:134-140. [PMID: 38323262 PMCID: PMC10839929 DOI: 10.5005/jp-journals-10071-24643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/30/2023] [Indexed: 02/08/2024] Open
Abstract
Background Prone position ventilation (PPV) causes improvement in oxygenation, nevertheless, mortality in severe acute respiratory distress syndrome (ARDS) remains high. The changes in the driving pressure (DP) and its role in predicting mortality in moderate to severe ARDS patients receiving PPV is unexplored. Methods A prospective observational study, conducted between September 2020 and February 2023 on moderate-severe ARDS patients requiring PPV. The values of DP and oxygenation (ratio of partial pressure of arterial oxygen to fraction of inspired oxygen [PaO2/FiO2]) before, during, and after PPV were recorded. The aim was to compare the DP and oxygenation before, during and after PPV sessions among moderate- severe ARDS patients, and determine the best predictor of mortality. Results Total of 52 patients were included; 28-day mortality was 57%. Among the survivors, DP prior to PPV as compared to post-PPV session reduced significantly, from 16.36 ± 2.57 cmH2O to 13.91 ± 1.74 cmH2O (p-value < 0.001), whereas DP did not reduce in the non-survivors (19.43 ± 3.16 to 19.70 ± 3.15 cmH2O (p-value = 0.318)]. Significant improvement in PaO2/FiO2 before PPV to post-PPV among both the survivors [92.75 [67.5-117.75]) to [205.50 (116.25-244.50)], (p-value < 0.001) and also among the non-survivors [87.90 (67.75-100.75)] to [112 (88.00-146.50)], (p-value < 0.001) was noted. Logistic regression analysis showed DP after PPV session as best predictor of mortality (p-value = 0.044) and its AUROC to predict mortality was 0.939, cut-off ≥16 cmH2O, 90% sensitivity, 82% specificity. The Kaplan-Meier curve of DP after PPV ≥16 cmH2O and <16 cmH2O was significant (Log-rank Mantel-Cox p-value < 0.001). Conclusion Prone position ventilation-induced decrease in DP is prognostic marker of survival than the increase in PaO2/FiO2. There is a primacy of DP, rather than oxygenation, in predicting mortality in moderate-severe ARDS. Post-PPV session DP ≥16 cmH2O was an independent predictor of mortality. How to cite this article Todur P, Nileshwar A, Chaudhuri S, Shanbhag V, Cherisma C. Changes in Driving Pressure vs Oxygenation as Predictor of Mortality in Moderate to Severe Acute Respiratory Distress Syndrome Patients Receiving Prone Position Ventilation. Indian J Crit Care Med 2024;28(2):134-140.
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Affiliation(s)
- Pratibha Todur
- Department of Respiratory Therapy, Manipal College of Health Professionals, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anitha Nileshwar
- Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Souvik Chaudhuri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vishal Shanbhag
- Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Celine Cherisma
- Department of Respiratory Therapy, Manipal College of Health Professionals, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Bai Y, He F, Yu Y, Li J. Application of prone position ventilation in ventilation strategies for patients with COVID-19. Technol Health Care 2024; 32:1835-1846. [PMID: 38007683 DOI: 10.3233/thc-230874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND Patients with coronavirus disease 2019 (COVID-19) have been shown to die mainly due to disease-induced acute respiratory distress syndrome (ARDS). Prone position ventilation (PPV) is an important ventilation strategy in the management of patients with ARDS. OBJECTIVE To investigate the application of PPV in ventilation strategies for patients with COVID-19. METHODS Three hundred patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Shanxi Bethune Hospital from January 2020 to June 2021 were retrospectively collected. Based on body position and conscious state, all patients were divided into three groups: intubation prone position group (n= 110), awake prone position group (n= 90) and supine position group (n= 100); The acute physiology and chronic health evaluation II (APACHE-II) scores, blood gas indicators, complications and other relevant clinical indicators were compared among the three groups. One-way ANOVA was used to compare means between multiple groups for quantitative information that conformed to a normal distribution. Repeated measures ANOVA was used for repeated measures data. Component comparisons were made using the Kruskal-Wallis H rank sum test for non-normally distributed quantitative data. RESULTS One-way repeated-measures ANOVA main effect analysis showed different effects of different treatments on PaO2 in patients with COVID-19 (F treatment = 256.231, P< 0.05), with the order of awake prone position group > intubation prone position group > supine position group. The effects of the three different treatments on P/F in patients with COVID-19 (F treatment = 311.661, P< 0.05), with the order of awake prone position group > supine position group > intubation prone position group; Moreover, the three treatments had different effects on APACHE II scores in patients with COVID-19 (F treatment = 201.342, P< 0.05), with the order of intubation prone position group > supine position group > awake prone position group. CONCLUSION Intubation prone position and awake prone position can improve lung function to some extent in patients with COVID-19, and should be applied as early as possible in patients with COVID-19-induced ARDS.
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Affiliation(s)
- Yuan Bai
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Vascular Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Fang He
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Biliary and Pancreatic Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Ying Yu
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Vascular Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Jia Li
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Vascular Surgery Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
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Xu CC, Xu JL, Wang XF, Meng S, Ye S, Tang XM, Lei W. Prone position reduces the risk of patients with mild or moderate COVID-19 progressing to severe or even critical cases: a retrospective study. Eur J Med Res 2022; 27:149. [PMID: 35962440 DOI: 10.1186/s40001-022-00776-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background To investigate whether prone position can reduce the risk of patients with mild or moderate COVID-19 who progress to severe or critical illness. Methods The prone position group was treated in prone position on the day of admission in addition to conventional treatment. Indicators such as saturation of pulse oximetry (SpO2), heart rate, blood pressure, respiratory rate, and prone position-related adverse events were recorded before prone ventilation, 5 min after prone position and 30 min after prone position. Meanwhile, the cases of severe and critical patients, the percentage of transformation and the final clinical outcome of this group were analyzed. Conversion rates and mortality were calculated for patients with mild or moderate COVID-19 retrieved from the database who received only conventional care without combined prone positioning as control group. Results (1) A total of 34 patients were included in prone position group. There were significant differences in SpO2 between the first 4 days after admission and the day of discharge (F = 3.17, P < 0.001). (2) The main complications were back and neck muscle soreness (55.9%), followed by abdominal distension (8.9%). (3) In control group, a total of 4873 cases of mild and moderate patients were included from 19 literatures, with an average deterioration rate of 22.7% and mortality rate of 1.7%. (4) In prone position group, there were no severe or critical transformation cases and also no death cases. The prone position group had a significantly lower deterioration rate when compared with the control group (χ2 = 9.962, P < 0.01). Conclusion Prone position improves SpO2 in patients with mild or moderate COVID-19. It can also reduce the percentage of mild or moderate patients progressing to severe or critical patients. The application of prone position is a simple, feasible, safe and effective treatment method in such patients.
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Manzur-Sandoval D, Vega-Sánchez ÁE, Guadarrama-Pérez C. A man with severe SARS-CoV-2 pneumonia and oliguria. Vis J Emerg Med 2022; 27:101273. [PMID: 35136845 DOI: 10.1016/j.visj.2022.101273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/26/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022]
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Xu YL, Mi YP, Zhu MX, Ren YH, Gong WJ, Fu WJ, Wang HM, Ye L, Wang Y, Zhou XY, Chen Y, Chen YY, Gu LQ, Gu Y, Jia B, Hu J, Hu XJ. Feasibility and effectiveness of prone position ventilation technique for postoperative acute lung injury in infants with congenital heart disease: study protocol for a prospective randomized study. Trials 2021; 22:929. [PMID: 34922610 PMCID: PMC8684128 DOI: 10.1186/s13063-021-05895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background Prone position ventilation is a widely used lung protection ventilation strategy. The strategy is more convenient to implement in children compared to adults. Due to the precise mechanism of improving oxygenation function, development of pediatric prone ventilation technology has been largely focused on children with acute respiratory distress syndrome. There is a paucity of high-quality studies investigating the effects of prone position ventilation after pediatric cardiac surgery. The purpose of this study is to evaluate the feasibility and effectiveness of prone position ventilation in infants who develop postoperative acute lung injury after surgery for congenital heart disease. Methods A single-center, randomized controlled trial of pediatric patients with acute lung injury after surgery for congenital heart disease who will receive prone position ventilation or usual care (control group). A total of 68 children will be enrolled according to the inclusion criteria. The main outcome measures will be lung compliance and oxygenation index. The secondary outcomes will be duration of mechanical ventilation, length of stay in cardiac intensive care unit, reintubation rate, and complication rate. Discussion This study will investigate the feasibility and effectiveness of prone position ventilation techniques in children who develop postoperative acute lung injury after surgery for congenital heart disease. The results may help inform strategies to improve airway management after surgery for congenital heart disease. Trial registration ClinicalTrials.gov NCT04607993. Initially registered on 29 October 2020.
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Affiliation(s)
- Yu-Lu Xu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Ya-Ping Mi
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Meng-Xin Zhu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Yue-Hong Ren
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Wei-Juan Gong
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Wei-Jia Fu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Hui-Mei Wang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Lan Ye
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Yin Wang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Xiao-Yan Zhou
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Yan Chen
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Yan-Yan Chen
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Li-Qiong Gu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China
| | - Ying Gu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China.
| | - Bing Jia
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China.
| | - Jing Hu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China.
| | - Xiao-Jing Hu
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, China.
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Zhang JC, Li T. Awake extracorporeal membrane oxygenation support for a critically ill COVID-19 patient: A case report. World J Clin Cases 2021; 9:5963-5971. [PMID: 34368315 PMCID: PMC8316967 DOI: 10.12998/wjcc.v9.i21.5963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/30/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A critically ill coronavirus disease 2019 (COVID-19) patient complicated by acute respiratory distress syndrome is reported. The patient survived following treatment with awake veno-venous extracorporeal membrane oxygenation (ECMO).
CASE SUMMARY A 53-year-old male patient attended our hospital following a cough for 11 d and fever for 9 d. According to his computed tomography (CT) scan and real-time reverse transcription–polymerase chain reaction assay of a throat swab, nucleic acid was positive, confirming that he had COVID-19. He was subsequently transferred to the intensive care unit due to respiratory failure. The patient received antiviral drugs, a small dose of glucocorticoid, and respiratory support, including mechanical ventilation, but the treatment effect was poor. On the 28th day after admission, veno-venous ECMO and prone position ventilation (PPV) were performed, combined with awake ECMO and other comprehensive rehabilitation measures. On the 17th day of ECMO, the patient started to improve and his chest CT and lung compliance improved. ECMO was discontinued after 27 days, and mechanical ventilation was also discontinued after 9 days. The patient was then transferred to the rehabilitation department.
CONCLUSION COVID-19 can damage lung tissues and cause evident inflammatory exudation, thus affecting oxygenation function. Awake ECMO, PPV, and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.
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Affiliation(s)
- Jing-Chen Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Tong Li
- Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Subgroup of Critical Respiratory Diseases. [Standardized protocol of prone position ventilation in patients with acute respiratory distress syndrome]. Zhonghua Nei Ke Za Zhi 2020; 59:781-7. [PMID: 32987480 DOI: 10.3760/cma.j.cn112138-20200430-00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Prone position ventilation (PPV) is an effective treatment for patients with moderate/sever acute respiratory distress syndrome (ARDS), which can improve oxygenation and reduce mortality. Due to the uneven distribution of medical resources in China, the compliance of PPV is quite low. Standardized protocol of PPV is still unavailable in lots of intensive care units. Subgroup of Critical Respiratory Diseases, Chinese Society of Critical Care Medicine, Chinese Medical Association established a standardized protocol.The aim of the present protocol is to improve the standardized application of PPV in China.
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Zou L, Sun J, Liu Y, Zhang W, Jiang W, Yuan S, Shi Q. Surviving 2019 novel coronavirus pneumonia: A successful critical case report. Heart Lung 2020; 49:692-695. [PMID: 32861887 PMCID: PMC7440228 DOI: 10.1016/j.hrtlng.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
Prone position ventilation therapy should be considered when P/F ratio was still below 150mmHg after intubation in patients of COVID-19. Acute cor pulmonale(ACP) was often complicated with ARDS caused by COVID-19, dobutamine and the prone position ventilation therapy would be effective. High-Flow nasal cannula(HFNC) oxygen therapy could be as sequential strategy to reduce the risk of reintubation and postextubation respiratory failure, and was safe enough during the current COVID-19 outbreak. Cardiorespiratory function support therapy was the core of surviving COVID-19, and it was better to start early to achieve good prognosis.
Background . An outbreak of acute respiratory illness was proved to be infected by a novel coronavirus, officially named Coronavirus Disease 2019 (COVID-19) from World Health Organization (WHO), was confirmed first in Wuhan, China, and has become endemic worldwide, which was a serious threaten to public health all over the world. Herein, we reported a successful critical case of COVID-19 and shared our experience of treatment, which would do a favor for other COVID-19 patients. Case summary . A 65-year-old man, Wuhan citizen, was infected by COVID-19, and his pulmonary lesions progressed quickly in five days. On admission to Tongji Hospital, Wuhan, China, the immediate arterial blood gas(ABG) analysis showed the PaO2/FiO2(P/F) ratio was 134.4mmHg, moderate acute respiratory distress syndrome(ARDS) was diagnosed. Emergency tracheal intubation was performed, and the initial ventilator mode and parameters were set up based on the lung-protective ventilation strategy, but the P/F ratio could not be improved, and then the prone position ventilation was carried out for four consecutive days, as long as 16 hours every day, the P/F ratio rose to 180mmHg approximately, which still did not reach to the standard of extubation. And then we found that it was complicated with acute cor pulmonale(ACP) by ultrasound examination, dobutamine and diuretic were used for the treatment of ACP caused by ARDS successfully, and the P/F ratio went up to about 250mmHg. Seven days later after admission, the endotracheal intubation was successfully removed, after extubation, High-Flow nasal cannula(HFNC) oxygen therapy was used as a sequential strategy to prevent reintubation. Ultimately, he was discharged on day 34 after admission. Conclusion . Our case presented the treatment process of a critical COVID-19. Effective therapy was crucial to heal COVID-19, and organ function support therapy, especially the cardiorespiratory function support therapy, was the core of treatment.
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Affiliation(s)
- Lei Zou
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China.
| | - Jiakui Sun
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Ying Liu
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Wenhao Zhang
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Wei Jiang
- Tongji Hospital, Wuhan, Hubei Province, China
| | - Shoutao Yuan
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Qiankun Shi
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing, Jiangsu Province, China
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Carsetti A, Damia Paciarini A, Marini B, Pantanetti S, Adrario E, Donati A. Prolonged prone position ventilation for SARS-CoV-2 patients is feasible and effective. Crit Care 2020; 24:225. [PMID: 32414420 PMCID: PMC7226707 DOI: 10.1186/s13054-020-02956-w] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Andrea Carsetti
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Agnese Damia Paciarini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Benedetto Marini
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Simona Pantanetti
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Erica Adrario
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Abele Donati
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy.
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.
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Shi J, Wang C, Cui Y, Zhang Y. Extracorporeal membrane oxygenation with prone position ventilation successfully rescues infantile pertussis: a case report and literature review. BMC Pediatr 2018; 18:377. [PMID: 30501615 PMCID: PMC6267074 DOI: 10.1186/s12887-018-1351-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/19/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Bordetella pertussis can cause fatal illness with severe acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT). CASE PRESENTATION A 6-month-old non-vaccinated boy with B. pertussis infection who developed ARDS was treated by extracorporeal membrane oxygenation (ECMO). During his ECMO support stage, sudden occurred decreasing of ECMO flow implied increasing intrathoracic pressure. The airway spasm followed caused sudden drop of ventilator tidal volume as well as poor lung compliance. Prone position ventilation and bundle care were conducted as lung protection ventilator strategy. After 297-h of ECMO support, the patient was weaned off ECMO, and extubated one week later. CONCLUSIONS In this patient with severe ARDS caused by Bordetella pertussis, ECMO was performed for cardiopulmonary support and rescued the infant with severe pertussis. During ECMO support period, prone position ventilation and care bundle nursing strategy contributed to the relief of continuous airway spasm.
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Affiliation(s)
- Jingyi Shi
- Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China
| | - Chunxia Wang
- Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China.,Institute of Pediatric Critical Care, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China
| | - Yun Cui
- Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China
| | - Yucai Zhang
- Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China. .,Institute of Pediatric Critical Care, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
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Singh P, Ramasethu R, Sharma A. Prone ventilation and critical care management of severe ARDS and multiorgan failure in a young patient. Med J Armed Forces India 2012; 70:85-8. [PMID: 24623954 DOI: 10.1016/j.mjafi.2012.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 08/19/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Parikshit Singh
- Classified Specialist (Anaesthesiology & Critical Care), Command Hospital (CC), Lucknow 226002, India
| | - Rajshree Ramasethu
- Senior Advisor (Medicine & Nephrology), INHS Asvini, Colaba, Mumbai, India
| | - Amit Sharma
- Senior Advisor (Anaesthesiology), Command Hospital (CC), Lucknow 226002, India
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