As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related to the judicious application of external pressure may yield benefit. Recent observations made in late-phase patients with severe ARDS caused by COVID-19 (C-ARDS) have revealed unexpected mechanical responses to local chest wall compressions over the sternum and abdomen in the supine position that challenge the clinician’s assumptions and conventional bedside approaches to lung protection. These findings appear to open avenues for mechanism-defining research investigation with possible therapeutic implications for all forms and stages of ARDS.
【저자키워드】 COVID-19, Prone position, ARDS, mechanical ventilation, Chest wall, Respiratory mechanics, External pressure, Abdominal pressure, 【초록키워드】 Variation, lung, Intervention, Local, response, Chest, therapeutic, Research, Patient, Supine position, prone positioning, observation, severe ARDS, Stage, assumption, abdomen, implication, approach, recent, benefit, Lung protection, caused, form, transpulmonary pressure, 【제목키워드】 Chest, Lung compliance, Improving,