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Doctors say positioning sickest coronavirus patients on their stomachs is saving their lives '100 percent'

This positioning will increase the amount of oxygen reaching the lungs. It is life-saving because the sickest patients gasp for breath
UPDATED APR 15, 2020
(Getty Images)
(Getty Images)

Some doctors have claimed that they are "saving the lives" of the sickest COVID-19 patients by making a small and a simple tweak: placing them on their stomachs instead of their backs.

This positioning will increase the amount of oxygen reaching the lungs. It is life-saving because the sickest patients gasp for breath. Their lungs fail to function, and their blood runs low on oxygen. Hence, they are often connected to machines called ventilators to pump oxygen into the bodies.

"We're saving lives with this, one hundred percent,"  Dr Mangala Narasimhan, the regional director for critical care at Northwell Health, which owns 23 hospitals in New York, told CNN. "It's such a simple thing to do, and we've seen remarkable improvement. We can see it for every single patient," she added.

"Once you see it work, you want to do it more, and you see it work almost immediately," Dr Kathryn Hibbert, director of the medical ICU at Massachusetts General Hospital, told CNN.

This is not a new idea. Seven years ago, French doctors published a study making a case for this positioning otherwise called the prone positioning. They found that it could reduce the chances of people dying from Acute Respiratory Distress Syndrome — a condition resulting from infections such as influenza and now, COVID-19. 

"Patients can benefit from prone treatment when it is used early and in relatively long sessions," they wrote in their study. US doctors have since adopted this method.
 
With COVID-19 in the picture now, doctors are increasingly adopting prone positioning. More recently, Chinese experts also published a study highlighting its benefits. They also went to add that some patients benefited from lying on the belly even when ventilators failed to help them.

“It indicates that some patients do not respond well to high positive pressure and respond better to prone positioning in bed (facing downward),” Haibo Qiu, professor at the South East University School of Medicine in Nanjing, China, and co-author of the paper published in the American Journal of Respiratory and Critical Care Medicine, said in the statement.

After lying on the stomach, the patient's oxygen levels in the blood jumped to 98%, from 85% (Getty Images)

In the US, doctors observed its effects on a patient. After lying on the stomach, the patient's oxygen levels in the blood jumped to 98%, from 85%, according to CNN. This has prompted some doctors to place patients on their stomachs for at least 16 hours a day. 

Oxygen reaches the lungs more easily when patients lie face down. Lying on the back, on the other hand, obstructs oxygen supply to the lungs due to a patients' bodyweight.

"By putting them on their stomachs, we're opening up parts of the lung that weren't open before," Hibbert said.

This strategy, however, does not come without limitations. Patients placed on ventilators will need more sedation to lie in that position, leading to a prolonged stay in intensive care.

Another concern is when doctors recommend it to patients who are not sick enough to placed on a ventilator. Because they do not get sedated, maintaining the same position for hours is a challenge. To get around this problem, health workers are making some patients lie face down for at least four hours, split into two sessions.

"Most are willing to give it a try," Hibbert said. "How long they stay in that position varies from person to person, whether they're comfortable falling asleep in that position, or if they get bored and want to turn over to their backs," she added.

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