Effect of Prone Position onV/Q Matching in Non-intubated Patients With COVID-19

NCT ID: NCT04754113

Last Updated: 2022-01-25

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 14 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-02-08
• Study Completion Date: 2022-01-15

Brief Summary

A prospective physiologic study, in participants with COVID-19-related pneumonia requiring supplemental oxygen (standard oxygen therapy or high-flow nasal cannula (HFNC)) less than 24 hours. The investigators assessed the effect of prone position on ventilation inhomogeneity and ventilation/perfusion mismatch by electrical impedance tomography (EIT).

Detailed Description

Once enrolled, an EIT dedicated belt containing 16 electrodes was placed around the participant's chest at the fifth or sixth intercostal space and connected it to an EIT monitor (PulmoVista 500; Dräger Medical GmbH, Lübeck, Germany).

Baseline data were collected during supine position (timepoint SP1), including demographic and anthropometric data, a baseline arterial blood gas measurement, and ventilation parameters including type of supplemental oxygen, respiratory rate, fractional concentration of oxygen in inspired air (FiO2). The participants received instructions of end expiratory occlusion lasting at least 10 seconds and, 1 seconds after the start, a bolus of 10 mL of 5% NaCl solution was injected via the central venous catheter. Subsequently, each participant was helped into the prone position and data collection，end expiratory occlusion and 10% NaCl solution injection were preformed again after approximately 30 min (timepoint PP1). The participant was then encouraged to maintain the prone position for at least 3 h before being helped back into the supine position. Clinical data collection, end expiratory occlusion and injection of a bolus of 10 mL of 5% NaCl solution were repeated again 1 h after resupination (timepoint SP2).

Conditions

Covid19

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

prone position

patients from supine to prone for at least 3 hours than re-supine

Group Type: EXPERIMENTAL

prone position

Intervention Type: OTHER

patient was helped into the prone position, patient received instructions of end expiratory occlusion lasting at least 10 seconds and, 1 seconds after the start, a bolus of 10 mL of 5% NaCl solution was injected via the central venous catheter

Interventions

prone position

patient was helped into the prone position, patient received instructions of end expiratory occlusion lasting at least 10 seconds and, 1 seconds after the start, a bolus of 10 mL of 5% NaCl solution was injected via the central venous catheter

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. aged 18 to75 years

2. admitted to intensive care unit with a confirmed diagnosis of COVID-19-related pneumonia

3. requiring supplemental oxygen (standard oxygen therapy or high-flow nasal cannula (HFNC)) less than 24 hours,

4. gave written or witnessed verbal informed consent.

Exclusion Criteria

1. uncollaborative or had an altered mental status,

2. New York Heart Association class above II

3. history of severe chronic obstructive pulmonary disease

4. Contraindications to the use of EIT (e.g., presence of pacemaker or chest surgical wounds dressing) or prone position (as decided by the attending physician)

5. Impending intubation (on the basis of clinical judgment, including clinical and physiological parameters).

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Southeast University, China

OTHER

Sponsor Role: lead

Responsible Party

Ling Liu

Director

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ling Liu

Role: STUDY_DIRECTOR

Zhongda Hospital, School of Medicinr, Southeast Univerty

Locations

Ling Liu

Nanjing, Jiangsu, China

Countries

China

References

Chao Y, Yuan X, Zhao Z, Frerichs I, Li Z, Sun Q, Chen D, Zhang R, Qiu H, Liu L. Physiologic effects of prone positioning on gas exchange and ventilation-perfusion matching in awake patients with AHRF. BMC Pulm Med. 2024 Dec 4;24(1):600. doi: 10.1186/s12890-024-03411-0.

Reference Type: DERIVED

PMID: 39663512 (View on PubMed)

Other Identifiers

COVID-19 PPV

Identifier Type: -

Identifier Source: org_study_id