Covid19
Conditions
Keywords
Awake prone, Self prone
Brief summary
The primary objective of this study is to explore the physiological mechanism of awake, self proning among patients with acute hypoxemic respiratory failure induced by COVID-19, using LUS in the first three days and explore the predictive value of LUS in patients' outcome.
Detailed description
Lung ultrasound (LUS) has recently gained popularity among the imaging methods to perform bedside assessment of critically ill patients to guide clinical management. LUS is a non-invasive and easy-to-perform procedure that provides precise data on lung aeration, lung recruitment, lung morphology, and lung perfusion. Studies have shown that LUS is a useful tool in monitoring lung reaeration in intubated patients diagnosed with traditional ARDS undergoing prone positioning; however there are mixed findings in terms of the use of LUS in predicting potential prone positioning response. A recent study found that the non-intubated COVID-19 patients who responded to prone positioning had more pronounced disturbances of aeration in posterior regions, however, they only investigated patients' response to the first prone positioning and the information for the patients' outcome is lacking. In our previous study with intubated COVID-19 patients, we found that patients' response to the subsequent prone positioning had higher predictive value than the response to the first prone positioning. Therefore, the primary objective of this study is to explore the physiological mechanism of awake, self proning among patients with acute hypoxemic respiratory failure induced by COVID-19, using LUS in the first three days and explore the predictive value of LUS in patients' outcome.
Interventions
None listed
Sponsors
Hospital Civil de Guadalajara
Rush University Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
1. Adult subjects 18 years and older, 2. Confirmed COVID-19 diagnosis 3. Acute hypoxemic respiratory failure (SpO2/FiO2 or PaO2/FiO2 \<300) 4. Ordered self-prone positioning per medical team
Exclusion criteria
1. Pregnant 2. Palliative care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lung Ultrasound Score post prone in day 1 | Post prone in day 1 | Patients' response of oxygenation using Lung ultrasound score |
| SpO2/FiO2 pre prone in day 1 | pre prone in day 1 | Patients' response of oxygenation using SpO2/FiO2 |
| SpO2/FiO2 post prone in day 1 | post prone in day 1 | Patients' response of oxygenation using SpO2/FiO2 |
| SpO2/FiO2 pre prone in day 2 | Pre prone in day 2 | Patients' response of oxygenation using SpO2/FiO2 |
| SpO2/FiO2 post prone in day 2 | Post prone in day 2 | Patients' response of oxygenation using SpO2/FiO2 |
| SpO2/FiO2 pre prone in day 3 | Pre prone in day 3 | Patients' response of oxygenation using SpO2/FiO2 |
| SpO2/FiO2 post prone in day 3 | Post prone in day 3 | Patients' response of oxygenation using SpO2/FiO2 |
| Lung Ultrasound Score pre prone in day 1 | Pre prone in day 1 | Patients' response of oxygenation using Lung ultrasound score |
| Lung Ultrasound Score pre prone in day 2 | Pre prone in day 2 | Patients' response of oxygenation using Lung ultrasound score |
| Lung Ultrasound Score post prone in day 2 | Post prone in day 2 | Patients' response of oxygenation using Lung ultrasound score |
| Lung Ultrasound Score pre prone in day 3 | Pre prone in day 3 | Patients' response of oxygenation using Lung ultrasound score |
| Lung Ultrasound Score post prone in day 3 | Post prone in day 3 | Patients' response of oxygenation using Lung ultrasound score |
Countries
Mexico, United States
Outcome results
None listed