|
?:abstract
|
-
SESSION TITLE: Global Case Report Posters SESSION TYPE: Global Case Reports PRESENTED ON: October 18-21, 2020 INTRODUCTION: In Covid-19 patients hospitalized in Wuhan, 20-41% developed lung disease including ARDS with a mortality rate of almost 50% 1 Traditional methods of monitoring lung infection such as CT scan, Ultrasound, and X-ray are infeasible at scale, especially due to the risks of cross-contamination Forced Oscillation Technique (FOT) may provide a quick, inexpensive, and simple way (logistics and minimal patient effort) to monitor COVID-19 patients at home or point-of-care settings FOT measures lung mechanics with tidal, rested breathing, and does not require patient training FOT measures respiratory impedance, a combination of resistance (openness of the airways) and reactance (elasticity of the airways) at different frequencies (denoting small vs large airways) Assessment of lung mechanics has been shown as a predictor for ARDS and acute lung injury (ALI) and may be crucial for early intervention for COVID-19 patients2-3 Characterization as Symptomatic, Exposed, Infectious, and Recovered is insufficient for patients discharged to home or holding facilities and inadequately gathers information to describe the course, risk of deterioration, and lung recovery Pulse oximetry alone is insufficient in the face of the \'happy hypoxic\' CASE PRESENTATION: Homeless patients are followed by Public Health and quarantined at a motel for monitoring We used a portable FOT device, PulmoScan (Cognita Labs, USA), to measure respiratory mechanical impedance of COVID-19 patients and assess the feasibility for monitoring at home or point-of-care settings COVID-19 patients (male, age 45-55) were recruited from a homeless shelter at Oxnard, CA, USA, for daily lung function monitoring using PulmoScan A single device was used to monitor multiple patients during daily testing routines by taking adequate precautions, personal protection equipment, and anti-viral, anti-bacterial filters were used The parameters were resistances and reactances at frequencies 5-30Hz (R5-R30, X5-X30), small airway resistance (R5-R20), resonant frequency (fres), and area under reactance (AX) DISCUSSION: Both patients were asymptomatic throughout the duration of the study However, the respiratory impedance was consistently higher in the first 5 days compared to the last 5 days of recovery On average, the following parameters were higher- R5(patient 1 by 16%, patient 2 by 17%), R10 (12%,10%), R15 (12%,9%), R20 (10%,9%), R25 (8%,9%), R30 (6%,9%), R5-R20 (291%,138%), AX (37%,54%), and fres (18%,21%), and the following were lower- X5 (17%,32%), X10 (41%,72%), X15 (80%,102%), X20 (36%,57%), X25 (16%,33%) and X30 (10%,24%) on the first 5 days compared to the last 5 days CONCLUSIONS: Monitoring COVID-19 patients using FOT is feasible in the point-of-care setting for daily tracking The changes in lung mechanics measured through FOT shows early promise as a method for tracking lung deterioration Reference #1: Wu, C , Chen, X , Cai, Y , Zhou, X , Xu, S , Huang, H , … & Song, J (2020) Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China JAMA Internal Medicine Reference #2: Chen, L , Chen, G Q , Shore, K , Shklar, O , Martins, C , Devenyi, B , … & Tuma, M (2017) Implementing a bedside assessment of respiratory mechanics in patients with acute respiratory distress syndrome Critical Care, 21(1), 84 ? Reference #3: Kostic, P , Zannin, E , Olerud, M A , Pompilio, P P , Hedenstierna, G , Pedotti, A , … & Dellaca, R L (2011) Positive end-expiratory pressure optimization with forced oscillation technique reduces ventilator induced lung injury: a controlled experimental study in pigs with saline lavage lung injury Critical Care, 15(3), R126 DISCLOSURES: Owner/Founder relationship with Cognita Labs Please note: $1-$1000 Added 05/31/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Removed 06/01/2020 by Rajoshi Biswas, source=W b Response Owner/Founder relationship with Cognita Labs Please note: >$100000 Added 06/01/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Removed 06/01/2020 by Rajoshi Biswas, source=Web Response Owner/Founder relationship with Cognita Labs Please note: >$100000 Added 06/01/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Advisory Committee Member relationship with ABMRCC Please note: $1-$1000 Added 03/31/2020 by Chris Landon, source=Web Response, value=Consulting fee Employee relationship with Cognita Labs LLC Please note: $20001 - $100000 Added 06/12/2020 by Ronak Patel, source=Admin input, value=Salary No relevant relationships by Eva Reeder, source=Web Response
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}