Monitoring bronchoalveolar lavage with electrical impedance tomography: first experience in a patient with COVID-19.

Fu, Yingyun; Zou, Rongrong; Wang, Shouhong; Wen, Junmin; Rong, Lei; Tang, Ming; Yu, Baojun; Cen, Fulan; Zhao, Zhanqi; Frerichs, Inez; Adler, Andy; Liu, Yingxia; Liu, Lei

OBJECTIVE Patients with the novel coronavirus disease (COVID-19) often have airways secretions that severely compromise ventilation. This study investigates electrical impedance tomography (EIT) monitoring of a therapeutic bronchoalveolar lavage (BAL) in a patient with COVID-19. APPROACH A patient with COVID-19 developed acute respiratory distress syndrome requiring mechanical ventilation. He received regional BAL to remove mucus in the small airways (20 ml ×5 times). Regional ventilation changes before BAL, 30 minutes after and in the following days were monitored with EIT. MAIN RESULTS Regional ventilation worsened shortly after BAL and improved in the following days. The improvement of the oxygenation was not exactly matching the ventilation improvement, which indicated a possible ventilation/perfusion mismatch. SIGNIFICANCE Therapeutic BAL might improve regional ventilation for COVID-19 and EIT could be a useful tool at the bedside to monitor the ventilation treatment of COVID-19.