In coronavirus disease-2019 (COVID-19)-related ARDS (C-ARDS), especially in the severeform, increased shunt rate, impaired ventilation/perfusion ratio (V/Q), hypoxic pulmonaryvasoconstriction inhibition, and increased immune microthrombosis may have similareffects on the right ventricle .The cardiopulmonary pathophysiology and outcomes ofC-ARDS vary, and this variability requires monitoring to follow the diagnosis andtreatment process. This study aimed to increase the treatment success of the proneposition in C-ARDS and to provide a prognostic factor for survival by analyzing andmonitoring heart-lung interactions. Therefore, we used transesophageal echocardiography(TEE) to evaluate the cardiopulmonary effects of prone position.
This prospective study included 30 moderate-to-severe C-ARDS patients who were treated
with prone position in the first 48 hours of invasive mechanical ventilation support. It
was evaluated with transesophageal echocardiography three times: before prone position
(PP) (T0), the first hour of PP (T1), and the first hour of returning to the supine
position (T0 + 24 hours) (T2) after 23 hours prone position treatment. Right ventricular
end-diastolic area/left ventricular end-diastolic area (RVEDA/LVEDA) was preferred right
ventricular evaluations as primer outcome. Static compliance (C-stat) was examined in the
evaluation of the pulmonary effect of prone position as secondary outcome.
Procedure: before prone position
It was evaluated with transesophageal echocardiography
Other Name: t0
Procedure: the first hour of prone position
It was evaluated with transesophageal echocardiography
Other Name: t1
Procedure: the first hour of returning to the supine position
It was evaluated with transesophageal echocardiography
Other Name: t2
Inclusion Criteria:
- >18 years
- Patients diagnosed with polymerase chain reaction/computed tomography results
- Moderate/severe severity class according to the Berlin ARDS classification
- Prone position applied in the first 48 h after orotracheal intubation in treatment
- Obtaining an informed consent form
Exclusion Criteria:
- Pulmonary embolism
- Pneumothorax
- Heart valve disease
- Pregnancy
- Perforated esophageal varices
- Coagulopathy
- Esophageal stricture
- Esophageal tumor
- Neck fracture
- Thrombocytopenia
- Gastrointestinal bleeding
- Previous stomach surgery
- Previous esophageal surgery
- Esophageal perforation
Bakirkoy Dr. Sadi Konuk Research Hospital
Istanbul 745044, Bakırköy, Turkey (Türkiye)
Not Provided