Lung mechanics in type L CoVID-19 pneumonia: a pseudo-normal ARDS

Abstract Background This study was conceived to provide systematic data about lung mechanics during early phases of CoVID-19 pneumonia, as long as to explore its variations during prone positioning. Methods We enrolled four patients hospitalized in the Intensive Care Unit of “M. Bufalini” hospital, Cesena (Italy); after the positioning of an esophageal balloon, we measured mechanical power, respiratory system and transpulmonary parameters and arterial blood gases every 6 hours, just before decubitus change and 1 hour after prono-supination. Results Both respiratory system and transpulmonary compliance and driving pressure confirmed the pseudo-normal respiratory mechanics of early CoVID-19 pneumonia (respectively, C RS 40.8 ml/cmH 2 O and DP RS 9.7 cmH 2 O; C L 53.1 ml/cmH 2 O and DP L 7.9 cmH 2 O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties throughout time (C RS,SUP 56.3 ml/cmH 2 O and C RS,PR 41.5 ml/cmH 2 O – P 0.37; C L,SUP 80.8 ml/cmH 2 O and C L,PR 53.2 ml/cmH 2 O – P 0.23). Conclusions Despite the severe ARDS pattern, respiratory system and lung mechanical properties during CoVID-19 pneumonia are pseudo-normal and tend to worsen during pronation. Trial registration Restrospectively registered.