actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2021-6.6-2.6actabiomedica-3137Research ArticleМОРФОЛОГИЯ, ФИЗИОЛОГИЯ И ПАТОФИЗИОЛОГИЯMORPHOLOGY, PHYSIOLOGY AND PATHOPHYSIOLOGYИзменения гемодинамики при переводе на неинвазивную ИВЛ у больных с новой коронавирусной инфекцией COVID-19Blood circulation changes associated with switching to non-invasive ventilation in COVID-19 patientshttps://orcid.org/0000-0003-4665-1960ШилинД. С.ShilinD. S.

 врач анестезиолог-реаниматолог; преподаватель кафедры физической культуры

672010, г. Чита, ул. Ленина, 8, Россия

672000, г. Чита, ул. Горького, 39А, Россия

Critical Care Physician; Lecturer at the Department of Physical Culture

Lenina str. 8, Chita 672010, Russian Federation 

Gorkogo str. 39A, Chita 672000, Russian Federation 

Untara100@gmail.comhttps://orcid.org/0000-0001-6408-239XШаповаловЮ. К.ShapovalovYu. K.

 ассистент кафедры оториноларингологии

672000, г. Чита, ул. Горького, 39А, Россия

 Teaching Assistant at the Department of Otorhinolaryngology

Gorkogo str. 39A, Chita 672000, Russian Federation 

https://orcid.org/0000-0002-3485-5176ШаповаловК. гShapovalovK. G.

 доктор медицинских наук, профессор, заведующий кафедрой анестезиологии и реанимации 

672000, г. Чита, ул. Горького, 39А, Россия

 Dr. Sc. (Med.), Professor, Head of the Department of Anesthesiology and Resuscitation 

Gorkogo str. 39A, Chita 672000, Russian Federation 

ГУЗ «Городская клиническая больница № 1»; ФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РоссииCity Clinical Hospital No. 1; Chita State Medical AcademyФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РоссииChita State Medical Academy 20212812202166-25157Copyright © Шилин Д.С., Шаповалов Ю.К., Шаповалов К.г., 20212021Шилин Д.С., Шаповалов Ю.К., Шаповалов К.г.Shilin D.S., Shapovalov Y.K., Shapovalov K.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3137

Обоснование. Пандемия Covid-19 привела к широкому использованию различных методов респираторной поддержки в сочетании с использованием прон-позиции. Совокупное влияние этих двух факторов на гемодинамику представляет практический интерес.Цель исследования: оценить влияние на гемодинамику манёвра пронпозиции у больных с COVID-19 при смене респираторной поддержки с кислородотерапии на неинвазивную вентиляцию лёгких (НИВЛ).Материалы и методы. Исследование выполнили с участием 17 пациентов (мужчины, женщины) с внебольничной полисегментарной вируснобактериальной пневмонией на фоне СOVID-19, у которых прогрессировала дыхательная недостаточность. Дизайн исследования предусматривал два этапа. Первый этап выполнялся, когда пациентам проводилась кислородная поддержка в виде инсуффляции увлажнённого кислорода потоком от 3 до 7 литров в минуту. Второй этап реализовывался после перехода к НИВЛ. Измерения осуществлялись комплексом аппаратно-программного неинвазивного исследования центральной гемодинамики методом объёмной компрессионной осциллометрии КАП ЦГосм-«Глобус» (Россия).Результаты. Установили, что при выполнении манёвра прон-позиции у больных с тяжёлым течением COVID-19 при переходе с кислородной поддержки на НИВЛ модуль разницы диастолического артериального давления изменялся с 2,5 (1,0; 8,2) до 8,0 (5,7; 14,0) при p = 0,016. При эскалации кислородной поддержки модуль разницы объёмной скорости сердечного выброса изменялся с 11,5 (9,5; 34,2) до 31,0 (15,7; 42,0) при p = 0,049.Заключение. У пациентов с внебольничной полисегментарной вируснобактериальной пневмонией на фоне СOVID-19 при выполнении манёвра прон-позиции после перевода на НИВЛ с кислородной поддержки изменялись параметры диастолического артериального давления и объёмная скорость сердечного выброса.

Background. Various methods of respiratory support in combination with prone positioning have been used during the COVID-19 pandemic. The effects of combination of these two factors on hemodynamics are of interest for clinical practitioners.The aim: to evaluate the effect of prone positioning on hemodynamics in COVID-19 patients depending on the method of respiratory support.Materials and methods. The study included 17 patients of both sexes diagnosed with COVID-19-associated community-acquired polysegmental viral and bacterial pneumonia with progressive respiratory failure. The study consisted of two stages. During the first stage, the patients were receiving respiratory support with humidified oxygen (3–7 liters per minute). The second stage was initiated after switching to noninvasive ventilation (NIV). The measurements were performed using a technique of volumetric compression oscillometry on a non-invasive hemodynamic monitoring system KAP CGosm-Globus (Russia).Results. The study showed that prone positioning in patients with severe COVID-19 when switching from oxygen therapy to NIV resulted in a change in the diastolic blood pressure difference module from 2.5 (1.0; 8.2) to 8.0 (5.7; 14.0) (p = 0.016). Escalation of respiratory support led to the changes in the left ventricular outflow tract velocity difference module from 11.5 (9.5; 34.2) to 31.0 (15.7; 42.0) (p = 0.049).Conclusions. Patients with community-acquired polysegmental viral and bacterial pneumonia associated with COVID-19 demonstrated changes in diastolic blood pressure and left ventricular outflow tract velocity as a result of prone positioning following switching from oxygen therapy to NIV.

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The authors declare that there are no conflicts of interest present.