Effects of a Chair Positioning Session on Awake Non-Intubated COVID-19 Pneumonia Patients: A Multicenter, Observational, and Pilot Study Using Lung Ultrasound

Abstract

Background: LUS is a validated tool for the management of COVID-19 pneumonia. Chair positioning (CP) may have beneficial effects on oxygenation and lung aeration, and may be an easier alternative to PP. This study assessed the effects of a CP session on oxygenation and lung aeration (LA) changes in non-intubated COVID-19 patients. Methods: A retrospective multicenter study was conducted in an ICU. We analyzed data from LUS exams and SpO2:FiO2 performed before/after a CP session in non-intubated COVID-19 patients. Patients were divided into groups of responders or non-responders in terms of oxygenation or LA. Results: Thirty-three patients were included in the study; fourteen (44%) were oxygenation non-responders and eighteen (56%) were oxygenation responders, while thirteen (40.6%) and nineteen (59.4%) patients were classified as LA non-responders and responders, respectively. Changes in oxygenation and LA before/after a CP session were not correlated (r = −0.19, p = 0.3, 95% CI: −0.5–0.17). The reaeration scores did not differ between oxygenation responders and non-responders (1 (−0.75–3.75) vs. 4 (−1–6), p = 0.41). The LUS score was significantly correlated with SpO2:FiO2 before a CP session (r = 0.37, p = 0.04, 95% CI: 0.03–0.64) but not after (r = 0.17, p = 0.35, 95% CI: −0.19–0.50). Conclusion: A CP session was associated with improved oxygenation and LA in more than half of the non-intubated COVID-19 patients.

The Role of POCUS to Face COVID-19: A Narrative Review

“…This kind of correlation was also observed for intubated patients [44]. So, LUS has also been used to evaluate responses to therapeutic acts such as non-invasive ventilation [45]; in a prospective observational study, it was observed that LUS score >12 was predictive of NIV failure [46] and it was also employed for prone positioning trial response [46,47].…”