Some intensive care unit doctors are championing a breathing technique to help increase oxygen flow for those infected with the new coronavirus that involves putting the patient on their belly.
The new coronavirus causes a respiratory infection that can make it difficult for people who have COVID-19, the disease caused by the virus, to breathe. This technique, which is a form of prone positioning, is aimed at helping people with symptoms increase the airflow to their lungs.
It was made popular by Dr. Sarfaraz Munshi at Queen’s Hospital in England, who posted a video of the technique on YouTube.
As of Tuesday afternoon, the video has been viewed over two million times, even receiving praise from J.K. Rowling, who tweeted that the method “helped a lot” while she was sick, possibly with the virus.
To perform Munshi’s technique, anybody with COVID-19 symptoms who may be experiencing trouble breathing should take six deep breaths in and hold their breath for five seconds before exhaling.
On the sixth deep breath, Munshi tells viewers to inhale, “do a big cough” and then repeat those steps one more time.
After that, the U.K. doctor recommends patients lie flat on their bellies with a pillow in front of them, taking slightly deeper breaths for the next 10 minutes.
“When we’re looking at the lung injury and damage caused by COVID-19, what we’re seeing and what we know about it is that it is not equally distributed throughout the lung,” Carolyn McCoy, director of professional practice for the Canadian Society of Respiratory Therapists, told Global News.
“Different areas of the lungs are affected differently by COVID-19 and, ultimately, by something called acute respiratory distress syndrome, which is what COVID-19 can culminate in.”
The way oxygen is circulated through our bodies is called ventilation perfusion matching. When a person has trouble breathing due to COVID-19, doctors will try to match air into lungs that aren’t being ventilated well.
In order to properly pump oxygen into the lungs and through the body, McCoy said there needs to be a close match between tiny air sacs called alveoli and the blood flowing past those alveoli, allowing a person to breathe.
Placing a person on their belly can change the way blood and air flow through the lungs, which is ideal for patients suffering from respiratory viruses like the novel coronavirus.
“When a patient is placed in the stomach-down position, that improves that matching,” she said.
Prone positioning, however, is nothing new.
Thomas Piraino, a respiratory therapist working at St. Michael’s Hospital in Toronto, said this particular method has been utilized in adult critical care for upwards of 20 years.
“It’s been studied as a method for trying to improve oxygen delivery throughout the body with acute respiratory distress syndrome, which many of these patients with COVID-19 are developing,” he said.
Using the traditional technique, patients would lie on their belly for 16 hours in a 24-hour period and then be placed on their back for eight hours to help with some of the swelling that can occur when patients remain in one position for too long.
Now, Piraino said it’s being used with COVID-19 patients who require intubation or ventilators. He added that doctors are being encouraged to prone the patient early and put them on their belly even before they get to the point where they’re in need of a ventilator to help them breathe.
When a person lies on their back, Piraino said it can create extra pressure. People have more lung tissue on the back side of their lungs, and remaining there for long periods of time can close off smaller airways.
“For a normal, healthy patient, that doesn’t matter. Most people will lie on their back when they’re sleeping or on their side,” he said.
But when a person is critically ill and fighting a potential viral pneumonia, Piraino said placing a person on their stomach can help expand the diaphragm, which is the main muscle people use when they breathe.
“By getting the patient off of their back, the hope is to improve the movement of air to the areas that have most tissue,” he said.
“And of course, the more tissue you have, the more blood flow you have.”