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“It’s that Easy”: Why Having a Covid-19 Patient on the Stomach Can Save Life | Health




On Friday, Dr. Mangala Narasimhan received an emergency call. A man with a Covid-19 in his forties is in a dire situation and her colleagues ask her to come to the intensive care unit of the Long Island Jewish Hospital to see if he needs life support. I wanted

Before I came there, Narasimhan told the other doctor, point the patient at his stomach and see if it helps.

Narasimhan did not have to go to the ICU. The flip worked.

Placing a sick coronavirus patient on the abdomen, called doctors in the prone position, helps doctors increase the amount of oxygen that reaches the lungs.

“We’ve saved 100% of our lives,” said Narasimhan, regional head of emergency care at Northwell Health, which has 23 hospitals in New York. “This is a very simple thing and we have seen some amazing improvements. All patients can see it.”

Dr. Catherine Hibbert, head of the Medical ICU at Massachusetts General Hospital, said:

“We have parts of our lungs open”

Patients with coronavirus often die of ARDS, or acute respiratory distress syndrome. The same syndrome also kills patients with influenza, pneumonia and other illnesses.

Seven years ago, a French doctor New England Medical Journal ARDS patients using ventilators have been shown to be less likely to die when placed on the stomach of a hospital.

Since then, US physicians have, to varying degrees, placed ventilated ARDS patients on their stomachs.

Now they have doubled in coronavirus patients with this, and it is paying off. When a Long Island Jewish patient was placed on his stomach, his oxygen saturation, a measure of his blood oxygen, went from 85% to 98%, a huge jump.

Ventilated patients typically stay in the stomach for about 16 hours a day, moving their back for the rest of the day. This will give the doctor more access to the front and make it easier to perform the necessary treatment.

Paramedics say that it seems to help when you’re in the abdomen because oxygen can reach your lungs more easily. When you’re on your back, the weight of your body actually crushes a portion of your lungs.

“By placing them on their stomachs, we are opening parts of the lung that were not open before,” Hibbert said.

Belly or back choice

Placing a ventilated coronavirus patient on the stomach has a downside.

Ventilated patients require more sedation when in the stomach. This means staying longer in ICU. In mass general, about one-third of coronavirus patients with ventilators occupy the stomach.

Some hospitals place patients with coronavirus in the stomach who are not in the intensive care unit.

At Mass General, nurse “proning teams” encourage patients outside the ICU to visit their stomachs. Since it may be uncomfortable for a sedated patient to spend 16 hours in the stomach, nurses try to spend at least 4 hours in two hours.

“Most people are willing to give it a try,” Hibbert said. “The time they stay in that position really depends on who you are, whether you can comfortably sleep in that position, or whether you want to be bored and turn your back.”

Since a 2013 French study only included patients on ventilators, it is not completely clear how less severe patients affect the position of the stomach.

They are so sick at the Rush University Medical Center that their stomach position isn’t as bad as requiring a ventilator to breathe, but it does need additional oxygen supplied through the nasal canal. I am studying whether it helps patients.

their Clinical trialPatients are randomly assigned to be in the stomach or back, according to David Vines, chairman of Rush’s Department of Cardiopulmonary Sciences.

“We’ll see if proning helps, and if so, how long they should be in a prone position,” Vines said.


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