Proning: A life-saving therapy for severe COVID-19 patients

Md Billal Hossen :
Everybody is looking for the vaccine of COVID-19 but any effective vaccine is not invented yet. Most of the people in the world are trying different types of treatment methods to treat COVID-19 patients. Among all the therapy used for COVID-19 patients to improve oxygen saturation, the most effective therapy is Proning. According to Jack Stewart, a pulmonologist, “the term ‘proning’ basically means putting a patient in the prone position, or flat on their belly with their chest and face down, rather than on their back”. A study published in JAMA Internal Medicine suggests that more than 40% of individuals hospitalized for severe and critical COVID-19 developed Acute Respiratory Distress Syndrome (ARDS) and over 50% of those diagnosed died from the disease. In the case of ARDS the COVID-19 patient suffering from severe hypoxia (a condition where oxygen level of the blood becomes very low). The majority of the COVID-19 patient died due to the insufficiency of oxygen in the blood. To increase oxygen supply to the blood generally, oxygen flow is given from the cylinder for each severe COVID-19 patient. But sometimes it doesn’t work. So there is an alternative way to increase oxygen saturation of the blood and the process is termed as proning. As the coronavirus affects the human lung and damages the lung cell through an overreaction of the immune system called cytokine storm. The cytokine storm damages most of the cells of the lung and obstructs the passage of oxygen via blood. The oxygen saturation level of severe patient drops down to 40 percent to 50 percent, where the normal oxygen saturation level is above 95 percent. So immediate supply of oxygen is needed for the severe patient. We can use proning therapy to improve the oxygen level very quickly. When a patient places in the prone position (on the stomach or belly) the blocked lung cells become open and start ingesting oxygen from the blood. Thus oxygen level may increase rapidly with proper proning. Thus proning can save a life. It is a very easy task but needs an expert to carry out this work. Most importantly, to carry out this process a registered nurse and a therapist is needed. This process does not need any special equipment and medicine so it is a cheaper method to enhance oxygen saturation. Though it is an effective method for increasing oxygen level, it has some limitations such as airway obstruction, dislodgement of endotracheal tube, pressure-related skin injuries, facial and airway edema (swelling), hypotension (low blood pressure), arrhythmias (irregular heartbeat/rate). We need to practice proning with expert personnel very carefully. Hopefully, it will help to increase the oxygen saturation level in severe COVID-19 patients. Be diligent and lead a healthy life.

(Md Billal Hossen is a MS Student, Department of Applied Nutrition and Food
Technology Islamic University, Bangladesh).