Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Monaldi Arch Chest Dis · Apr 2021
Meta AnalysisAwake prone positioning in non-intubated patients for the management of hypoxemia in COVID-19: A systematic review and meta-analysis.
Coronavirus disease-2019 (COVID-19) may lead to hypoxemia, requiring intensive care in many patients. Awake prone positioning (PP) is reported to improve oxygenation and is a relatively safe modality. We performed a systematic review of the literature to evaluate the available evidence and performed meta-analysis of the effect of awake PP in non-intubated patients on improvement in oxygenation and reducing the need for intubation. ⋯ There was a significant improvement in PaO2: FiO2 ratio, PaO2, and SpO2 during awake PP. To conclude, there is limited evidence to support the efficacy of awake PP for the management of hypoxemia in COVID-19. Further RCTs are required to study the impact of awake PP on key parameters like avoidance of mechanical ventilation, length of stay, and mortality.
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Monaldi Arch Chest Dis · Mar 2021
The initial experience of COVID-19 vaccination from a tertiary care centre of India.
To the Editor Drugs Controller General of India (DCGI) has approved the Bharat biotech vaccine against COVID-19, which is a locally manufactured inactivated vaccine named ''COVAXIN'' in collaboration with the Indian council of medical research (ICMR) on 3rd January 2021 for emergency use along with the "Covishield" Oxford-AstraZeneca vaccine manufactured locally by the Serum Institute of India... *The Safdarjung COVID-19 Vaccination group: KR Meena (Professor, Paediatrics), U Venkatesh (Assistant Professor, Community Medicine), Pushpa Kumari (Associate Professor, Medicine), Sonal Burman (Specialist, Medicine), Neeraj Kumar Gupta (Professor and Head, Pulmonary Medicine), Nitesh Gupta (Assistant Professor, Pulmonary Medicine), Rohit Kumar (Assistant Professor, Pulmonary Medicine), Swetabh Purohit (Senior resident, Pulmonary Medicine), Arjun Ramaswamy (Senior resident, Pulmonary Medicine).
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Monaldi Arch Chest Dis · Mar 2021
Observational StudyRole of awake prone positioning in patients with moderate-to-severe COVID-19: an experience from a developing country.
There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. ⋯ No major complication of PP was recorded. Awake prone positioning is a valuable and safe therapeutic adjunct that can be applied in patients with moderate-to-severe COVID-19. It can also be included in the home-based management protocols of COVID-19 to improve patient outcomes and mitigate the burden on health care facilities.
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Monaldi Arch Chest Dis · Feb 2021
Case ReportsExertional dyspnea and hemoptysis in an adolescent: is it tuberculosis only?
Unilateral pulmonary artery atresia (UPAA), commonly detected in childhood, can occasionally present in adulthood with typical symptoms of recurrent pulmonary infections, dyspnoea on exertion and hemoptysis. An 18-year-old girl presented with complaints of cough, dyspnea on exertion and hemoptysis. Chest radiograph revealed dilated pulmonary trunk, signs of left sided volume loss and cavitating lesion in left lower zone. ⋯ Diagnosis of left sided UPAA with pulmonary tuberculosis was established. She responded well to the anti-tubercular therapy. This case highlights the importance of awareness about UPAA as a possible differential for exertional dyspnea, recurrent chest infections, hemoptysis and pulmonary hypertension in adults.
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Monaldi Arch Chest Dis · Dec 2020
Case ReportsPlatypnea-orthodeoxia in a patient with severe COVID-19 pneumonia.
COVID-19 pneumonia has a significant case fatality rate and no effective antiviral drugs are available even after 9 months of the pandemic. The spectrum of COVID-19 disease ranges from asymptomatic cases to severe ARDS with myriad manifestations. ⋯ He complained of worsening shortness of breath and hypoxemia which was found to be mainly positional. After ruling out other causes, he was labeled as a case of platypnea-orthodeoxia syndrome due to underlying lung involvement. It is important to be aware of this condition in the context of COVID-19 which can be easily diagnosed bedside with pulse oximetry.