CHANGES OF HEMODYNAMICS DURING THE DEVELOPMENT OF RESPIRATORY FAILURE IN PATIENTS WITH SEVERE FORMS OF COVID-19

Abstract

Background. The search for effective predictors of the severity of COVID-19 is an important problem in medical science at the present stage. In the pathogenesis of the severe course of a new coronavirus infection, changes in the state of hemodynamics are essential. Aim: to identify hemodynamic predictors of decompensated respiratory failure in patients with COVID-19. Materials and methods. The study was carried out on 100 patients of both sexes with community-acquired polysegmental viral-bacterial pneumonia against the background of COVID-19. Next, the patients were divided into 2 groups based on the development of severe respiratory failure. The 1st group included 50 patients who did not require mechanical ventilation, the second included patients who were either undergoing mechanical ventilation at the time of the study or will be undergoing it in the future. The studies were carried out using a complex of hardware-software non-invasive study of central hemodynamics using volumetric compression oscillometry. Results. In patients with progression of respiratory failure against the background of the new coronavirus infection COVID-19, the value of stroke volume and index is 1.27 and 1.16 times less before the prone position, as well as 1.3 and 1.23 times after the prone position according to compared with patients in the favorable group. In addition, in group 2, the volumetric ejection velocity in the supine position was 1.26 times less, and in the stomach position it was 1.22 times less. The compliance of the vascular wall and the reaction of precapillaries in patients who required mechanical ventilation were lower by 1.19 and 1.81 times before proning, and by 1.28 and 2.04 times after proning. Conclusions. In patients with progression of severe respiratory failure against the background of the new coronavirus infection COVID-19, changes in stroke volume and index, volumetric ejection velocity, and vascular wall compliance were identified.