Lung ultrasound monitoring of CPAP effectiveness on SARS-CoV-2 pneumonia: A case report

  • Marco Montanari Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.
  • Pierpaolo De Ciantis Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.
  • Andrea Boccatonda | andrea.boccatonda@aosp.bo.it Medicina d’Urgenza e Pronto Soccorso, Policlinico Sant’Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna; UOSD Ecografia Internistica, “G. d’Annunzio” University, Chieti, Italy.
  • Marta Venturi Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.
  • Giuseppe d'Antuono Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.
  • Gianfilippo Gangitano Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.
  • Giulio Cocco UOSD Ecografia Internistica, “G. d’Annunzio” University, Chieti, Italy.
  • Damiano D'Ardes UOSD Ecografia Internistica, “G. d’Annunzio” University, Chieti, Italy.
  • Cosima Schiavone UOSD Ecografia Internistica, “G. d’Annunzio” University, Chieti, Italy.
  • Fabrizio Giostra Medicina d’Urgenza e Pronto Soccorso, Policlinico Sant’Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Tiziana Perin Medicina d’Urgenza e Pronto Soccorso, Ospedale Infermi, Rimini, Italy.

Abstract

SARS-CoV-2 infection is characterized by extremely heterogeneous features, going from cases with few symptoms to severe respiratory failures. Chest Computed Tomography (CT) is currently the gold-standard imaging method, although burdened by the risk of exposure to ionizing radiation and management / organizational concerns. In particular, the critical patient undergoing ventilation (invasive or not) seems to be difficult to monitor by repeated CT scan over time. We report the case of a 55-year-old male patient subjected to Continuous Positive Airway Pressure (CPAP) and prone positioning, in which the use of ultrasound monitoring allowed to verify the effectiveness of the pressure support used in recruiting previously atelectasis lung areas. Lung ultrasound can guide pulmonary recruitment and pronation maneuvers in patients undergoing non-invasive ventilation. Ultrasound can identify atelectatic lung areas, which demonstrate an alveolar re-expansion following the setting of high PEEP values, as underlined by the reappearance of pleural/air interface.

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Published
2020-12-23
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Section
Case Reports
Keywords:
Ultrasound, Covid-19, pneumonia, CPAP, ventilation, prone position
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How to Cite
Montanari, M., De Ciantis, P., Boccatonda, A., Venturi, M., d’Antuono, G., Gangitano, G., Cocco, G., D’Ardes, D., Schiavone, C., Giostra, F., & Perin, T. (2020). Lung ultrasound monitoring of CPAP effectiveness on SARS-CoV-2 pneumonia: A case report. Emergency Care Journal, 16(3). https://doi.org/10.4081/ecj.2020.9333