1921
image of Case Report: Lung Ultrasound for the Guidance of Adjunctive Therapies in Two Invasively Ventilated Patients with COVID-19
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Two patients with respiratory failure due to confirmed COVID-19 were examined using bedside lung ultrasound (LUS) shortly after intubation and start of invasive ventilation. In the first patient, LUS revealed extensive atelectatic areas. A recruitment maneuver was applied, resulting in some reaeration of areas that showed atelectasis, and some improvement in oxygenation was observed. Oxygenation improved further with the use of prone positioning. In the second patient, LUS showed diffuse abnormalities without atelectatic areas, and ventilation proceeded without a recruitment maneuver but with prone positioning. These two cases illustrate how LUS could be useful in identifying different lung morphologies early after the start of invasive ventilation and help decide on adjunctive therapies. This has possible implications for ventilator management in resource-limited settings, with limited availability of chest computed tomography and blood gas analyzers. Tailoring invasive ventilation based on LUS findings early after the start of invasive ventilation is feasible, but this should be further evaluated in future studies.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.20-0538
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  • Received : 25 May 2020
  • Accepted : 02 Sep 2020
  • Published online : 09 Sep 2020
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