Journal Information
Vol. 48. Issue 7.
Pages 386-391 (July 2024)
Download PDF
More article options
Vol. 48. Issue 7.
Pages 386-391 (July 2024)
Original article
Changes in pulmonary mechanics from supine to prone position measured through esophageal manometry in critically ill patients with COVID-19 severe acute respiratory distress syndrome
Cambios en la mecánica pulmonar producidos por el cambio de la posición supina a la posición prono medidos por manometría esofágica en pacientes críticamente enfermos con Síndrome de Distrés Respiratorio Severo por COVID-19
Ismael Maldonado-Beltrána, Martín Armando Ríos-Ayalaa, Iván Armando Osuna-Padillaa, Nadia Carolina Rodríguez-Moguelb, Gustavo Lugo-Goytiaa, Carmen Margarita Hernández-Cárdenasa,
Corresponding author

Corresponding author.
a Departamento de Áreas Críticas, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Ciudad de México, Mexico
b Departamento de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Ciudad de México, Mexico
This item has received
Article information
Full Text
Download PDF
Figures (1)
Tables (2)
Table 1. Clinical and demographical characteristics of patients with ARDS and COVID-19.
Table 2. Pulmonary mechanics in critically-ill patients with COVID-19 when changing from SP to PP.
Show moreShow less

To describe changes in pulmonary mechanics when changing from supine position (SP) to prone position (PP) in mechanically ventilated (MV) patients with Acute Respiratory Distress Syndrome (ARDS) due to severe COVID-19.


Retrospective cohort.


Intensive Care Unit of the National Institute of Respiratory Diseases (Mexico City).


COVID-19 patients on MV due to ARDS, with criteria for PP.


Measurement of pulmonary mechanics in patients on SP to PP, using esophageal manometry.

Main variables of interest

Changes in lung and thoracic wall mechanics in SP and PP


Nineteen patients were included. Changes during first prone positioning were reported. Reductions in lung stress (10.6 vs 7.7, p=0.02), lung strain (0.74 vs 0.57, p=0.02), lung elastance (p=0.01), chest wall elastance (p=0.003) and relation of respiratory system elastances (p=0.001) were observed between patients when changing from SP to PP. No differences were observed in driving pressure (p=0.19) and transpulmonary pressure during inspiration (p=0.70).


Changes in pulmonary mechanics were observed when patients were comparing values of supine position with measurements obtained 24h after prone positioning. Esophageal pressure monitoring may facilitate ventilator management despite patient positioning.

Critically ill
Pulmonary mechanics
Prone position
Esophageal pressure
Esophageal manometry

Describir los cambios en la mecánica pulmonar de posición supino (SP) a posición prono (PP) en pacientes con ventilación mecánica (VM) con Sindrome de Insuficiencia Respiratoria Agudo Severo (SDRA) por COVID-19.


Cohorte retrospective.


Unidad de Cuidados Intensivos Respiratorios del Instituto Nacional de Enfermedades Respiratorias, Ciudad de México.


Se incluyeron un total de 19 pacientes con criterios para PP.


medición de la mecánica pulmonar en pacientes de SP a PP utilizando manometría esofágica.

Variables de interés principales

Cambios en la mecanica pulmonar y de la pared torácica, medidas mediante manometría esofágica de posición supino a posición prono.


Se observó una disminución en los valores medidos de estrés pulmonar (10,6 vs 7,7, p=0,02), “strain” pulmonar (0,74 vs 0,57, p=0,02), elastancia pulmonar (p=0,01), elastancia de la pared torácica (p=0,003) y en la relación de las elastancias del sistema respiratorio (p=0,001) tras el cambio de SP a PP. No se encontraron diferencias en la presión de conducción (p=0,19) ni en la presión transpulmonar durante la inspiración.


Se observaron cambios en la mecánica pulmonar al comparar los valores en posición supino y los medidos 24horas posteriores a la posición prono. El monitoreo de la presión esofágica puede ser de utilidad para el manejo del ventilador independientemente e la posición del paciente.

Palabras clave:
Pacientes críticos
Mecánica pulmonar
Posición prono
Presión esofágica
Manometría esofágica


These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC ( )and click the link to the magazine.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Medicina Intensiva (English Edition)

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Medicina Intensiva (English Edition)
Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?