PMC8222048_01
Time-series results for computed tomography (CT). Time-series results for chest CT in a 73-year-old man with coronavirus disease-related acute respiratory distress syndrome. (A) CT on day 1 showing atelectasis of the dorsal lower lobe and multiple bilateral ground-glass shadows. (B) CT on day 41 showing an improvement in infiltrative shadows. (C) CT on day 56 showing exacerbation of infiltrative shadows in both lungs. (D) CT on day 121 showing an improvement in infiltrative shadows.
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Chest computed tomography (CT) showed atelectasis of the dorsal lower lobe and multiple bilateral ground-glass shadows (Fig. 1-A). NMBAs were terminated on day 41 after confirming a decrease in the inflammatory response and an improvement in infiltrative shadows on CT (Fig. 1-B). CT performed on day 121 showed improvement in pulmonary damage to a certain level (Fig. 1-D).
Schematic of phrenic nerve block. This diagram shows a continuous phrenic nerve block.
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From days 94-124, bilateral continuous phrenic nerve block (Fig. 2) with 1.5% lidocaine (total: 2-4 cc/h continuous infusion) suppressed the
Ventilator waveforms. The left side of the waveform was seen before the application of the nerve block, and the right side was seen after the application of the nerve block. This waveform shows a reduction in (A) tidal change in oesophageal pressure (DeltaPes) and (B) the electrical activity of the diaphragm (Edi).
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DeltaPes and electrical activity of the diaphragm (Edi) (Fig. 3). During this period, the patient remained awake, and his rehabilitation proceeded.