Does lying face down help COVID-19 patients breathe?

Bottom Line:

Initial evidence suggests potential improvement in oxygenation and reduced lung injury from patients adopting the prone position (lying face down and back up) in spontaneous and assisted breathing.

Reference:

Telias, I. et al. Is the Prone Position Helpful During Spontaneous Breathing in Patients With COVID-19? JAMA (2020). DOI:10.1001/jama.2020.8539

Date Published:

15 May 2020

Synopsis:

COVID-19 patients often have high respiratory drive due to a combination of high metabolic rate and inefficient ventilation. Excessive drive to breathe, coupled with inflammatory edema (swelling) and potential lung microthrombi (clots) contribute to a mismatch of ventilation and perfusion in the lung. The studies summarized in this article demonstrate that among the majority of patients who can tolerate a session of prone positioning, there was an improvement in oxygenation and decrease in respiratory rate. These effects were temporary and oxygenation returned to original values upon supination (patient flipping over).

Summary by: Mike Ge