Use of Lung Ultrasound in Evaluating Physiological Response to Awake Self Proning
Study Details
Study Description
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.
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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.
Study Design
Outcome Measures
Primary Outcome Measures
- 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 post prone in day 1 [Post 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
Eligibility Criteria
Criteria
Inclusion Criteria:
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Adult subjects 18 years and older,
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Confirmed COVID-19 diagnosis
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Acute hypoxemic respiratory failure (SpO2/FiO2 or PaO2/FiO2 <300)
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Ordered self-prone positioning per medical team
Exclusion Criteria:
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Pregnant
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Palliative care
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Rush University Medical Center | Chicago | Illinois | United States | 60612 |
| 2 | Hospital Civil Fray Antonio Alcalde | Guadalajara | Jalisco | Mexico | 44280 |
Sponsors and Collaborators
- Rush University Medical Center
- Hospital Civil de Guadalajara
Investigators
- Principal Investigator: Jie Li, Rush University
Study Documents (Full-Text)
None provided.More Information
Publications
- Avdeev SN, Nekludova GV, Trushenko NV, Tsareva NA, Yaroshetskiy AI, Kosanovic D. Lung ultrasound can predict response to the prone position in awake non-intubated patients with COVID-19 associated acute respiratory distress syndrome. Crit Care. 2021 Jan 25;25(1):35. doi: 10.1186/s13054-021-03472-1.
- Langer T, Brioni M, Guzzardella A, Carlesso E, Cabrini L, Castelli G, Dalla Corte F, De Robertis E, Favarato M, Forastieri A, Forlini C, Girardis M, Grieco DL, Mirabella L, Noseda V, Previtali P, Protti A, Rona R, Tardini F, Tonetti T, Zannoni F, Antonelli M, Foti G, Ranieri M, Pesenti A, Fumagalli R, Grasselli G; PRONA-COVID Group. Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients. Crit Care. 2021 Apr 6;25(1):128. doi: 10.1186/s13054-021-03552-2.
- Wang XT, Ding X, Zhang HM, Chen H, Su LX, Liu DW; Chinese Critical Ultrasound Study Group (CCUSG). Lung ultrasound can be used to predict the potential of prone positioning and assess prognosis in patients with acute respiratory distress syndrome. Crit Care. 2016 Nov 30;20(1):385.
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