Role of lung ultrasound during prone position among awake non-intubated patients experiencing COVID-19 associated ARDS

Abstract Background Early prediction of COVID-19 associated acute respiratory distress syndrome (ARDS) progression may be crucial in delivering adequate health care. The aim of this study was to assess whether the alteration in lung aeration evaluated by (LUS) can serve as a predictor of oxygenation response during prone position in awake non-intubated patients with COVID-19 associated ARDS. Methods Our study involved 65 patients (32 males and 33 females) who were admitted and isolated for treating COVID-19 infection at Mansoura University Hospitals, with mean age 61.26 ± 13.41 years. All included patients were asked and assisted for prone position for at least 6 h per day. Basal hemodynamics were recorded as well as every 1 h for 6 h of proning. Pleural and B line ultrasound scoring as well as PaO2/FiO2 ratio were obtained basal (pre proning) and after 6 h of prone position (post proning). Results There was statistically significant decrease between the right B line score pre and post prone position among regions 3, 4, 5, and 6 ( p < 0.05). However, there was no statistically significant change between B line score pre and post prone position among regions 1and 2 ( p > 0.05). As regard, the left B-line score , the current study found statistically significant decrease between pre and post prone position among the all regions 1, 2, 3, 4, 5, and 6 ( p < 0.05). Conclusion Lung ultrasound is a real time, bed side, sensitive, and quantitative tool to assess alteration in aeration in awake non-intubated patients with COVID-19 associated ARDS and can anticipate oxygenation response to prone position.