Healthcare workers and researchers have found out that flipping the patient in the prone position or lying down on the stomach serves as one of the effective measures to save the lives of COVID-19 patients especially who are in intensive care as reported by CNN. Mangala Narasimhan who is the regional director for critical care at Northwell Health which owns around 23 hospitals within New York City reported to CNN that we are saving lives with this prone position and that too around 100%. He further elaborates that it is one of the simplest things that we can do and says that we have seen a remarkable improvement in every single patient.
PRONE POSITION OPENING THE PARTS OF LUNGS FOR ENOUGH OXYGEN SUPPLY:
The idea of flipping the patients into a prone position is to allow their lungs to get enough oxygen. CNN further reports that a patient who was admitted at Long Island Jewish hospital in Queens flipped onto his stomach and he saw his oxygen saturation rate rise and move from 85-98%. Kathryn Hibbert who is the director of the medical ICU at Massachusetts General Hospital also reported CNN that by putting the patients on the stomach, we are trying to open up areas of the lungs that weren’t open before. The patients of COVID-19 usually die due to the ARDS which is the common symptom in other conditions as well like pneumonia, influenza, and others.
STUDIES THAT PROVE THE EFFICACY OF PRONE POSITION FOR COVID-19 PATIENTS:
According to the study published in The New England Journal of Medicine by seven French doctors, it was seen that prone position aids in reducing the mortality rates for patients who suffered from severe acute respiratory distress syndrome which is a type of respiratory failure that occurs because of the lung inflammation and this lung inflammation is similarly seen in COVID-19 patients. This study was however conducted on patients who were critically ill and were on ventilators. It is because of this reason that we don’t know whether the prone position is beneficial for people who are not severely ill.
According to the recent study which was published during March and was conducted in Wuhan, China at a hospital which was considered as the epicenter of the global COVID-19 pandemic. It was seen that lying down on the stomach was somehow helpful in some cases than applying external pressure over the lungs with the help of ventilators in coronavirus patients. This recent study is considered as the first descriptive behavior of the lungs in COVID-19 patients who are severely ill and are on mechanical ventilation and are receiving positive pressure, according to Haibo Qiu who is the professor at South East University School of Medicine in Nanjing, China and also serves as the co-author of a paper which was published in American Journal of Respiratory and Critical care medicine. Qiu concluded that it is seen that certain patients do not respond well to positive pressure by ventilators instead they respond better to the prone positioning in bed i.e. facing downwards and lying down on the stomach.
DIRE NEED OF MASSIVE CLINICAL TRIALS FOR APPROVAL OF PRONE POSITION FOR COVID-19 PATIENTS:
Despite the prior success of this prone position for severe acute respiratory distress syndrome. These trials are small in size and therefore, cannot be applied to the general population worldwide. Many patients are so severely ill that they cannot spend the entire day lying down on the hospital bed while facing downwards. US researchers are now focusing on turning the patients on their stomach and trying to perform clinical trials to find out the efficacy of the position for extra oxygen supply to the entire body. The ventilated patients are advised to lie down on their stomachs for 15-16 hours and for the rest of the time lying down on their back which allows the healthcare professionals to access the front side of the body for treatment.
THE IDEA TO CHOOSE BACK OR BELLY:
It is to understand that making critically ill patients sleep on their stomachs in ICU requires more sedation. During this pandemic, masses of the human population are affected by the virus due to which the sickest, as well as the mild symptomatic patients, are also placed on the stomach. To avoid sedating the patients outside ICU, the nurses at Mass General are trying their best to reach out to the patients and advise them to lie down on the stomach for four hours in two sessions so that they don’t feel uncomfortable.