Clinical efficacy of assisted intranasal ventilation after polysegmental pneumonia caused by the SARS-CoV-2 virus

Abstract

BACKGROUND: The development of ways of rehabilitation of patients after polysegmental viral pneumonia that enable the collapsed alveoli being transferred to a ventilated and actively perfused state is certainly relevant. In this regard, non-invasive respiratory support can be considered as a reasonable additional method of treatment for these patients.
 MATERIALS AND METHODS: The study included 40 patients after bilateral polysegmental pneumonia caused by the SARS CoV-2 virus. The first group of patients (21 people), in addition to the standard treatment, underwent non-invasive assisted intranasal ventilation in the BiPAP mode with a final expiratory pressure of 4-8 cm of water. Art. 60 minutes three times a day for 10-12 days. The second group (19 people) did not receive ventilation benefits. Before the start of therapy and at the end of the course, spirometry, computed tomography (CT) of the chest organs were performed with the calculation of the volume of the affected lung tissue according to the Thoracic VCAR program.
 RESULTS: upon completion of the course of treatment and rehabilitation measures in patients of the first group, the following was observed: a decrease in atelectatic changes and pneumofibrosis, an increase in the volume of ventilated areas of the lungs, the volume of the affected lung tissue according to CT significantly decreased (on average, up to 26 9.8%; p0.05). There was a significant improvement in the indicators of spirometry in the first group. The increase in FEV1 was 25-32%, while VC was 27-31%. When evaluating long-term pulse oximetry, the average saturation at night in these patients increased from 91.22.1 to 96.41.8 (p0.05). Clinical improvement in patients of the first group led to a decrease in bed-days to an average of 15.4, while in patients of the second group it averaged 23.4 days.
 CONCLUSION: The use of assisted intranasal ventilation returns the ventilation-perfusion ratio in atelectated areas of the lungs, which is confirmed by a significant improvement in clinical and instrumental parameters.