Monitoring bronchoalveolar lavage with electrical impedance tomography: first experience in a patient with COVID-19

Physiol Meas. 2020 Sep 10;41(8):085008. doi: 10.1088/1361-6579/abab1b.

Abstract

Objective: Patients with the novel coronavirus disease (COVID-19) often have airway secretions that severely compromise ventilation. This study investigates electrical impedance tomography (EIT) monitoring of a therapeutic bronchoalveolar lavage (BAL) in a patient with COVID-19.

Approach: A patient with COVID-19 developed acute respiratory distress syndrome requiring mechanical ventilation. He received regional BAL to remove mucus in the small airways (20 ml × 5). Regional ventilation changes before BAL, 30 min after and in the following days, were monitored with EIT.

Main results: Regional ventilation worsened shortly after BAL and improved in the following days. The improvement of the oxygenation did not exactly match the ventilation improvement, which indicated a possible ventilation/perfusion mismatch.

Significance: Therapeutic BAL might improve regional ventilation for COVID-19 and EIT could be a useful tool at the bedside to monitor the ventilation treatment of COVID-19.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus*
  • Bronchoalveolar Lavage / methods*
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / therapy*
  • Electric Impedance / therapeutic use*
  • Humans
  • Male
  • Monitoring, Physiologic / methods*
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / therapy*
  • Respiration, Artificial / methods*
  • Respiratory Distress Syndrome / diagnostic imaging
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / therapy
  • SARS-CoV-2
  • Tomography / methods