Application of high-frequency Doppler ultrasound for comparative assessment of the response of the microcirculatory bloodstream to artificial ventilation and therapy with an oxygen-helium mixture in patients with severe viral pneumonia caused by COVID-19

The aim. To perform a comparative analysis of microcirculatory bed (MCB) response in patients with viral pneumonia (COVID-19), severe course, aggravated by arterial hypertension on artificial lung ventilation (ALV) and thermal oxygen-helium mixture (OHM) therapy.

Materials and methods. 9 patients were on mask ALV and 13 received OHM therapy. The OHM therapy was performed at gas concentration: O2 – 30 %, He – 70 %; the OHM temperature at the heater output was +95 оС (patients received it with t= up to +65 оС). The blood flow parameters in the MCB were recorded by ultrasound dopplerograph, 20 MHz sensor on the nail shaft of the thumb.

Results. The study has shown that the blood flow parameters in MCB were variable in patients on ALV. The increase in the blood flow velocity in MCB was due to blood inflow through the arteriolar link as a result of high values of HR (up to 100 beats/min), which ranged 0.741 – 2.428 cm/s on different days of observation. The PI index was high – 1.332 , some days its value increased by 13.7–26.7 %. Capillary blood flow indicators were low and averaged 0.181 cm/s. After OHM therapy, the blood flow velocity increased in all links of MCB: in the arteriolar and capillary by 7 %, in the venular almost 3 times as compared to the primary study. The PI index decreased from 1.56 to 1.155, vascular tone RI from 0.87 to 0.714. The positive effect of OHM therapy was observed after 30 min, 60 min and on subsequent days of MCB monitoring. 

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