Effects of Body Position on Diaphragmatic Activity in Patients Requiring Noninvasive Ventilation for Acute Respiratory Failure COVID-19 Related

Study Overview
=================
Brief Summary
-----------------
The present investigation aims to assess the diaphragmatic thickening fraction, reflecting the diaphragmatic activity, during supine (baseline) and at 1 hour following prone position in patients assisted through non invasive ventilation due to hypoxemic acute respiratory failure related to COVID-19. Also, the impact of lung aeration and comfort were ascertained in the same setting

Detailed Description
-----------------
Primary aim is to asses the effects of body position on diaphragmatic thickening fraction (primary aim) and lung aeration and vital sign (secondary aims) in patents assisted via noninvasive ventilation (NIV) for hypoxemic acute respiratory failure (hARF) associated to COVID-19. All adult patients, admitted for hARF due to COVID-19 and requiring NIV were enrolled. Diaphragmatic thickening fraction, lung aeration assessed through ultrasound, comfort, and grade of sedation-agitation as well as vital signs, i.e., peripheral oxygen saturation, blood pressure, and breathing pattern were monitored during noninvasive ventilation in supine and after 1 hour following the switch to prone position.

Official Title
-----------------
Effects of Body Position on Diaphragmatic Activity in Patients Requiring Noninvasive Ventilation for Acute Respiratory Failure COVID-19 Related

Conditions
-----------------
Noninvasive Ventlation, COVID-19 Respiratory Infection, Diaphragm Injury

Intervention / Treatment
-----------------
* Other: Prone position


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: COVID-19 infection, Age > 18 years, NIV application, ICU admission Exclusion Criteria: Pregnancy, All the conditions contraindicating prone position and NIV

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Prone position|Patients were assisted in NIV in supine position that was switched in prone position for clinical purpouse|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diaphragmatic thickening fraction | The fraction of diaphragmatic thickness variations during respiratory cycle | At baseline, in supine position | 
| Diaphragmatic thickening fraction | The fraction of diaphragmatic thickness variations during respiratory cycle | After 1 hour following prone position application | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung aeration | Lung aeration assessed through sonography | At baseline, in supine position | 
| Peripheral oxygen saturation | Reflects the grade of peripheral oxygenation | At baseline, in supine position | 
| Lung aeration | Lung aeration assessed through sonography | after 1 hour following prone position application | 
| Peripheral oxygen saturation | Reflects the grade of peripheral oxygenation | after 1 hour following prone position application |