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10.1007/s00134-021-06562-4 http://scihub22266oqcxt.onion/10.1007/s00134-021-06562-4 34825929!8617364!34825929     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Intensive+Care+Med 2022 ; 48 (1): 56-66 Nephropedia Template TP {{tp|p=34825929|t=2022. Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia |pdf=|usr=}}{{34825929}} gab.com Text Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia JO: Intensive Care Med http://www.kidney.de/pget.php?&tw=1&pmid=34825929 #FOAvip PURPOSE: This study aimed at investigating the mechanisms underlying the oxygenation response to proning and recruitment maneuvers in coronavirus disease 2019 (COVID-19) pneumonia. METHODS: Twenty-five patients with COVID-19 pneumonia, at variable times since admission (from 1 to 3 weeks), underwent computed tomography (CT) lung scans, gas-exchange and lung-mechanics measurement in supine and prone positions at 5 cmH(2)O and during recruiting maneuver (supine, 35 cmH(2)O). Within the non-aerated tissue, we differentiated the atelectatic and consolidated tissue (recruitable and non-recruitable at 35 cmH(2)O of airway pressure). Positive/negative response to proning/recruitment was defined as increase/decrease of PaO(2)/FiO(2). Apparent perfusion ratio was computed as venous admixture/non aerated tissue fraction. RESULTS: The average values of venous admixture and PaO(2)/FiO(2) ratio were similar in supine-5 and prone-5. However, the PaO(2)/FiO(2) changes (increasing in 65% of the patients and decreasing in 35%, from supine to prone) correlated with the balance between resolution of dorsal atelectasis and formation of ventral atelectasis (p = 0.002). Dorsal consolidated tissue determined this balance, being inversely related with dorsal recruitment (p = 0.012). From supine-5 to supine-35, the apparent perfusion ratio increased from 1.38 +/- 0.71 to 2.15 +/- 1.15 (p = 0.004) while PaO(2)/FiO(2) ratio increased in 52% and decreased in 48% of patients. Non-responders had consolidated tissue fraction of 0.27 +/- 0.1 vs. 0.18 +/- 0.1 in the responding cohort (p = 0.04). Consolidated tissue, PaCO(2) and respiratory system elastance were higher in patients assessed late (all p < 0.05), suggesting, all together, "fibrotic-like" changes of the lung over time. CONCLUSION: The amount of consolidated tissue was higher in patients assessed during the third week and determined the oxygenation responses following pronation and recruitment maneuvers. Twit Text FOAVip Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia ????Intensive Care Med http://www.kidney.de/pget.php?&tw=1&pmid=34825929 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=34825929 #FOAvip English Wikipedia <ref>{{Cite pmid|34825929}}</ref> Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia #MMPMID34825929 Rossi S; Palumbo MM; Sverzellati N; Busana M; Malchiodi L; Bresciani P; Ceccarelli P; Sani E; Romitti F; Bonifazi M; Gattarello S; Steinberg I; Palermo P; Lazzari S; Collino F; Cressoni M; Herrmann P; Saager L; Meissner K; Quintel M; Camporota L; Marini JJ; Gattinoni L Intensive Care Med 2022[Jan]; 48 (1): 56-66 PMID34825929show ga PURPOSE: This study aimed at investigating the mechanisms underlying the oxygenation response to proning and recruitment maneuvers in coronavirus disease 2019 (COVID-19) pneumonia. METHODS: Twenty-five patients with COVID-19 pneumonia, at variable times since admission (from 1 to 3 weeks), underwent computed tomography (CT) lung scans, gas-exchange and lung-mechanics measurement in supine and prone positions at 5 cmH(2)O and during recruiting maneuver (supine, 35 cmH(2)O). Within the non-aerated tissue, we differentiated the atelectatic and consolidated tissue (recruitable and non-recruitable at 35 cmH(2)O of airway pressure). Positive/negative response to proning/recruitment was defined as increase/decrease of PaO(2)/FiO(2). Apparent perfusion ratio was computed as venous admixture/non aerated tissue fraction. RESULTS: The average values of venous admixture and PaO(2)/FiO(2) ratio were similar in supine-5 and prone-5. However, the PaO(2)/FiO(2) changes (increasing in 65% of the patients and decreasing in 35%, from supine to prone) correlated with the balance between resolution of dorsal atelectasis and formation of ventral atelectasis (p = 0.002). Dorsal consolidated tissue determined this balance, being inversely related with dorsal recruitment (p = 0.012). From supine-5 to supine-35, the apparent perfusion ratio increased from 1.38 +/- 0.71 to 2.15 +/- 1.15 (p = 0.004) while PaO(2)/FiO(2) ratio increased in 52% and decreased in 48% of patients. Non-responders had consolidated tissue fraction of 0.27 +/- 0.1 vs. 0.18 +/- 0.1 in the responding cohort (p = 0.04). Consolidated tissue, PaCO(2) and respiratory system elastance were higher in patients assessed late (all p < 0.05), suggesting, all together, "fibrotic-like" changes of the lung over time. CONCLUSION: The amount of consolidated tissue was higher in patients assessed during the third week and determined the oxygenation responses following pronation and recruitment maneuvers. |*COVID-19[MESH] |*Respiratory Distress Syndrome[MESH] |Humans[MESH] |Lung/diagnostic imaging[MESH] |Prone Position[MESH] |Prospective Studies[MESH] |Pulmonary Gas Exchange[MESH]Mechanisms of oxygenation responses to proning and recruitment in COVI(epmc).pdf DeepDyve Pubget Overpricing