Effectiveness of diaphragm ultrasound to assess the failure of NIV: A case report
Keywords:
breathing inadequacy, noninvasive ventilation, diaphragmAbstract
The detection of failure risk factors in noninvasive ventilation supposes a challenge in the cases of hypoxemic respiratory failure in which it’s decided to utilize it as first support. The echo-graphic exploration could be an interesting tool in this sense. We present a case of hypoxemic respiratory failure due to secondary severe pneumonia to SARS-CoV-2 infection. The thickening fraction was evaluated by means of diaphragm echography, in two different occasions with two different levels of continuous positive airway pressure (CPAP). After this procedure it was noticed improvement in the oxygenation parameters and a reduction of the thickening fraction that suggests reduced work of breathing. At the eighth day, it was possible to retire the CPAP completely and after 12 days in the UCI the patient was discharged to the hospitalization room showing good evolution. The diaphragm echography can suppose another tool when valuing the possible failure of noninvasive ventilation. In the future quality works that really evaluate their utility will be necessary.
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References
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