Lung ultrasound monitoring of CPAP effectiveness on SARS-CoV-2 pneumonia: A case report
covid-19, pneumonia, prone position, ultrasound, Ventilation, CPAP
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.
Marco Montanari, Pierpaolo De Ciantis, Andrea Boccatonda, Marta Venturi, Giuseppe d'Antuono, Gianfilippo Gangitano, Giulio Cocco, Damiano D'Ardes, Cosima Schiavone, Fabrizio Giostra, Tiziana Perin