Journal Information
Vol. 47. Issue 3.
Pages 183 (March 2023)
Images in Intensive Medicine
Full text access
Diaphragmatic evaluation in patient with COVID-19 during the start of non-invasive mechanical ventilation
Evaluación diafragmática en paciente con COVID-19 durante el inicio de la ventilación mecánica no invasiva
Visits
801
V. Gascón Sáncheza,
Corresponding author
victorgascon83@gmail.com

Corresponding author.
, M.J. Segrera Rovirab, L. Bellver Boscha
a Servicio de Medicina Intensiva, Hospital Universitari de la Ribera, Alcira, Spain
b Servicio de Fisioterapia, Hospital Universitari de la Ribera, Alcira, Spain
This item has received
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

This is the case of a 66-year-old man admitted to the ICU due to COVID-19 after high-flow nasal oxygen failure at the conventional hospital ward setting. Non-invasive support (non-invasive ventilation) is initiated with the following parameters: BiPAP mode with IPAP of 12, EPAP of 9, and a FiO2 of 100% with a tidal volume of approximately 350−450 mL (6.25−8 mL/kg of ideal weight) with respiratory rate dropping from 30 to 23 breaths/min. The diaphragmatic ultrasound performed at admission reveals the presence of a regular diaphragmatic excursion of 2 cm. The patient is asked to take a deep breath (*). Inverted diaphragm motion occurs that triggers the use of accessory muscles. M mode is used. Diaphragmatic thickening of only 3% is reported. Nor the pressure or the volume change dramatically. Twenty-four hours later, failed later non-invasive ventilation is confirmed followed by the need for intubation. Figs. 1 and 2.

Figure 1
(0.18MB).
Figure 2
(0.13MB).
Copyright © 2021. Elsevier España, S.L.U. and SEMICYUC
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
es en

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

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