Hemodynamic Parameters After Prone Positioning of COVID-19 Patients

Abstract

Aim of the study. To examine the effect of prone positioning on hemodynamics in patients with COVID-19.Materials and methods. The study enrolled 84 patients of both sexes with community-acquired multisegmental viral and bacterial pneumonia associated with COVID-19, who were divided into groups according to the type of respiratory support. The tests were performed using the integrated hardware and software system for noninvasive central hemodynamic assessment by volumetric compression oscillometry.Results. We found that the pulse blood pressure velocity decreased from 281 [242.0; 314.0] to 252 [209; 304] mm Hg/s in patients with severe COVID-19 on oxygen support (p=0.005); volume ejection rate decreased from 251 [200; 294] to 226 [186; 260] ml/s (P=0.03); actual/estimated normalized vascular resistance ratio dropped from 0.549 [0.400; 0.700] to 0.450 [0.300; 0.600] (P=0.002), while the arterial wall compliance increased from 1.37 [1.28; 1.67] to 1.45[1.10; 1.60] ml/mm Hg (P=0.009). Prone positioning of patients on noninvasive lung ventilation associated with a reduction of linear blood flow rate from 40.0 [34.0; 42.0] to 42.5 [42.5; 47.25] cm/s (7=0.04) and arterial wall compliance from 1.4 [1.24; 1.50] to 1.32 [1.14; 1.49] ml/mm Hg (7=0.03). Prone positioning of patients on invasive lung ventilation did not result in significant hemodynamic changes.Conclusion. The greatest hemodynamic changes during prone positioning were found in patients on oxygen respiratory support, whereas the least significant alterations were seen in patients on invasive ventilatory support.

Keywords

• prone position
• covid-19
• hemodynamics
• noninvasive lung ventilation