Electrical Impedance Tomography and Prone Position During Ventilation in COVID-19 Pneumonia: Case Reports and a Brief Literature Review

Semin Cardiothorac Vasc Anesth. 2020 Dec;24(4):287-292. doi: 10.1177/1089253220958912. Epub 2020 Sep 13.

Abstract

At the end of 2019, a novel coronavirus (COVID-19) was identified as the cause of a cluster of pneumonia cases, with high needs of mechanical ventilation in critically ill patients. It is still unclear whether different types of COVID-19 pneumonia require different ventilator strategies. With electrical impedance tomography (EIT) we evaluated, in real time and bedside, the distribution of ventilation in the different pulmonary regions before, during, and after pronation in COVID-19 respiratory failure. We present a brief literature review of EIT in non-COVID-19 patients and a report of 2 COVID-19 patients: one that did not respond well and another one that improved during and after pronation. EIT might be a useful tool to decide whether prone positioning should or should not be used in COVID-19 pneumonia.

Keywords: COVID-19; electrical impedance tomography; pneumonia; prone position; ventilation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Betacoronavirus
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / therapy*
  • Electric Impedance*
  • Fatal Outcome
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / therapy*
  • Prone Position
  • Respiration, Artificial / methods*
  • Tomography / methods*

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2