In coronavirus disease-2019 (COVID-19)-related ARDS (C-ARDS), especially in the severe form, increased shunt rate, impaired ventilation/perfusion ratio (V/Q), hypoxic pulmonary vasoconstriction inhibition, and increased immune microthrombosis may have similar effects on the right ventricle .The cardiopulmonary pathophysiology and outcomes of C-ARDS vary, and this variability requires monitoring to follow the diagnosis and treatment process. This study aimed to increase the treatment success of the prone position in C-ARDS and to provide a prognostic factor for survival by analyzing and monitoring heart-lung interactions. Therefore, we used transesophageal echocardiography (TEE) to evaluate the cardiopulmonary effects of prone position.

This prospective study included 30 moderate-to-severe C-ARDS patients who were treated with prone position in the first 48 hours of invasive mechanical ventilation support. It was evaluated with transesophageal echocardiography three times: before prone position (PP) (T0), the first hour of PP (T1), and the first hour of returning to the supine position (T0 + 24 hours) (T2) after 23 hours prone position treatment. Right ventricular end-diastolic area/left ventricular end-diastolic area (RVEDA/LVEDA) was preferred right ventricular evaluations as primer outcome. Static compliance (C-stat) was examined in the evaluation of the pulmonary effect of prone position as secondary outcome.

Inclusion Criteria:

• >18 years
• Patients diagnosed with polymerase chain reaction/computed tomography results
• Moderate/severe severity class according to the Berlin ARDS classification
• Prone position applied in the first 48 h after orotracheal intubation in treatment
• Obtaining an informed consent form

Exclusion Criteria:

• Pulmonary embolism
• Pneumothorax
• Heart valve disease
• Pregnancy
• Perforated esophageal varices
• Coagulopathy
• Esophageal stricture
• Esophageal tumor
• Neck fracture
• Thrombocytopenia
• Gastrointestinal bleeding
• Previous stomach surgery
• Previous esophageal surgery
• Esophageal perforation

moderate/severe C-ARDS patients admitted to the Bakırköy Dr Sadi Konuk Training and Research Hospital Anesthesiology and Reanimation Clinic Intensive Care Unit, who received invasive mechanical ventilation support and applied prone position in the first 48 h were included.

Data available from the publication date can start If requested, data will be shared with medical doctors dealing with