Prone positioning for the COVID-19 patient - VIDEO
Doctors are finding that placing the sickest coronavirus patients on their stomachs -called prone positioning - helps increase the amount of oxygen that's getting to their lungs, CNN reports.
We're saving lives with this, one hundred percent," said Narasimhan, the regional director for critical care at Northwell Health, which owns 23 hospitals in New York. "It's such a simple thing to do, and we've seen remarkable improvement. We can see it for every single patient."
Prone positioning has been used as a treatment option for patients with acute lung injury or acute respiratory distress syndrome (ARDS) since the early 1970s. Prone position and extended prone position ventilation have been shown to increase end-expiratory lung volume, alveolar recruitment, and oxygenation in patients with severe hypoxemic and acute respiratory failure.
Patients with coronavirus often die of ARDS, or acute respiratory distress syndrome. The same syndrome also kills patients who have influenza, pneumonia and other diseases.
Doctors in the United States have been placing ventilated ARDS patients on their stomachs ever since the first publication by French doctors in the New England Journal of Medicine 7 years ago.
On their stomachs for 16 hours
The ventilated patients typically stay on their stomachs for about 16 hours a day, going on their backs for the rest of the time so doctors have better access to their front side and can more easily give them the treatments they need.
Critical care specialists say being on the belly seems help because it allows oxygen to more easily get to the lungs. While on the back, the weight of the body in effect squishes some sections of the lungs.
By putting them on their stomachs, we're opening up parts of the lung that weren't open before, doctors explain.
More sedation needed
The downside? Ventilated patients require more sedation when they're on their stomachs, which could mean a longer stay in the ICU. At the Massachusetts General Hospital, about a third of coronavirus patients on ventilators get placed on their stomachs, usually the ones who are sickest and have the most to gain from being in that position.
How to prone position a COVID-19 patient – see in the VIDEO BELOW provided by Mount Sinai staff in the US