French doctors discovered that flipping patients with Acute Respiratory Distress Syndrome (ARDS) on their stomach can save their life in 2013. Now it's being used during the Coronavirus Disease 2019 (COVID-19) pandemic.
CNN reported the technique, called prone positioning, saved the life of a 40-year-old man, according to Dr. Mangala Narasimhan, regional director for critical care at Northwell Health.
"Before I come over there, Narasimhan told the other doctor, try turning the patient over onto his stomach and see if that helps," Dr. Narasimhan said.
Going back to the past to solve the present
Prone positioning was first published in The New England Journal of Medicine. The researchers found out that patients in the prone position have better oxygenation than patients in the supine position. It also prevents injuries caused by wearing an oxygen ventilator.
The study concluded, "In patients with severe ARDS, early application of prolonged prone-positioning sessions significantly decreased 28-day and 90-day mortality." Surprisingly, ARDS is one of the conditions a person with COVID-19 develops.
According to Science Mag, "Some COVID-19 patients recover, sometimes with no more support than oxygen breathed in through nasal prongs. But others deteriorate, often quite suddenly, developing a condition called acute respiratory distress syndrome (ARDS)."
COVID-19 is the underlying pathology of pneumonia, Science Mag added. Some of its symptoms include coughing, fever, and rapid or shallow respiration. Prone positioning will give them more oxygen to breathe and more time for doctors and nurses more time to save a patient.
Prone positioning uses the weight of the body to squish some sections of the lungs, allowing oxygen to enter the lungs more.
No time to waste
Some hospitals, even if the theory doesn't have a large enough control group in the United States, are putting some of their patients on their belly, while the others remain on their back. One of them is Rush University Medical Center, which started the study Early Prone Positioning Combined With High-Flow Nasal Cannula Versus High-Flow Nasal Cannula in COVID-19 Induced Moderate to Severe ARDS.
The study will determine if the early use of prone positioning combined with High-Flow Nasal Cannula (HFNC) therapy "can avoid the need for intubation in COVID-19 induced moderate to severe ARDS patients."
With over 2.4M cases and 165,000 deaths due to COVID-19, hospitals and medical institutions are doing what they can to lessen the death toll. But some hospitals are still struggling to understand other aspects of the pandemic.
Joseph Levitt, a pulmonary critical care physician at the Stanford University School of Medicine, said COVID-19 isn't just attacking the lungs. It is attacking major parts of the body, such as the heart and kidneys.
A 53-year-old woman from Brescia, Italy, entered a local hospital with all the symptoms of a heart attack, yet didn't have one. These were actually signs of COVID-19: cardiac swelling and scarring, a weakened left ventricle, and damaged cardiac muscles.
But medical personnel can stop or slow down COVID-19's rampage throughout the body using prone positioning.
Dr. Kathryn Hibbert, the director of Massachusetts General Hospital's medical ICU, told CNN, "By putting them on their stomachs, we're opening up parts of the lung that weren't open before."
