Wuhan study shows lying face down improves breathing in severe COVID-19
Vital information regarding the effects of patient body positioning on the lungs of severe COVID-19 patients has just been released in a study published in the American Journal of Respiratory and Critical Care Medicine.
The first of it’s kind, the single centre observational study assessed the effect of prone (face down) and supine (face up) positioning in 12 patients in Wuhan Jinyintan Hospital, China, with severe COVID-19 infection-related acute respiratory distress syndrome (ARDS) using an index several of the researchers had developed prior, the Recruitment-to-Inflation ratio. The index measures lung recruitability, the response of the lungs to pressure.
All patients received mechanical ventilation, seven received at least one 24-hour session of prone positioning, and three received prone positioning and ECMO.
The patients who were alternated between supine and prone positioning had increased lung recruitability as compared with patients who did not receive prone positioning.
“It is only a small number of patients, but our study shows that many patients did not re-open their lungs under high positive pressure and may be exposed to more harm than benefit in trying to increase the pressure,” said Chun Pan, MD, also a professor with Zhongda Hospital, School of Medicine, Southeast University. “By contrast, the lung improves when the patient is in the prone position.
Considering this can be done, it is important for the management of patients with severe COVID-19 requiring mechanical ventilation.”
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