Supporting the body with hands and knees, crossing arms, lowering the head for deep breathing and coughing... At the end of last year, a video on how to perform prone position ventilation went viral online. It is reported that this posture can effectively move the adhesive substances and secretions at the bottom of the lungs, which helps to cough up secretions and improve breathing.
1、 Is this method really feasible?
Prone position, as a common treatment method in clinical practice, is highly effective for patients with lung diseases. Prone position ventilation (PPV) is a mechanical ventilation method that uses a turning bed, turner, or manual operation to allow patients to perform mechanical ventilation in a prone position as a lung protection strategy. It is mainly used to improve oxygenation in patients with acute respiratory distress syndrome (ARDS).
Prone position ventilation is commonly used as an adjuvant therapy for moderate to severe acute respiratory distress syndrome in clinical practice, which is relatively safe and effective. During the epidemic period of COVID-19 infection, prone ventilation has become one of the auxiliary methods for treatment. Clear non intubated prone ventilation can also improve hypoxemia, hypercapnia, lung compliance, and lung recoverability in COVID-19. Early implementation can curb the progression from mild to severe and critical conditions, and improve the clinical prognosis of severe and critical patients.
2、 Why does prone position ventilation have an effect?
The human lung tissue is composed of many alveoli, with 60% of the lung tissue located near the dorsal side of the body. There is a thin layer of lipoprotein inside the alveoli, known as "pulmonary surfactant", which can reduce the tension of the alveoli. The higher the tension, the more difficult it is to blow air. But because COVID-19 will destroy this layer of surfactant, the gas cannot be evenly distributed in the alveoli. When a person is lying on their back, the closer the alveoli are to the back under the influence of gravity, the smaller the alveoli, and the gas we inhale will be very lazy.
When lying down, under the influence of gravity, "water flows downwards", which is beneficial for better drainage of exudate from the alveoli in the back, reducing the pressure of the diaphragm on the dorsal lung tissue, making it easier for gas to enter the alveoli, and promoting a uniform distribution of gas in the lung tissue. This improves the exchange of qi and blood, removes carbon dioxide, alleviates hypoxia, and thus achieves the goal of protecting lung tissue.
3、 The advantages of prone position ventilation
(1) Improving blood circulation
During prone position ventilation, the internal organs will be located below the spine, which will not compress the blood vessels, and blood can flow smoothly.
（2） Reducing physical stress
Sleeping in a prone position can alleviate pressure on the spine and help improve the health of the cervical and lumbar vertebrae. In addition, prone position can also reduce muscle fatigue and help restore energy to the body.
（3） Improving respiratory diseases
Improving lung ventilation function is beneficial for better mechanical ventilation, and due to the higher position of the back, it is easier to drain secretions from the airway under the influence of gravity.
3、 Precautions for prone position ventilation
(1) Do not sleep immediately after a full meal
If you sleep immediately after a full meal, it can easily cause acid reflux and increase the risk of gastrointestinal diseases. Therefore, one should wait at least 2 hours after eating before going to bed.
（2） Avoid drinking and smoking
Drinking and smoking can cause damage to the respiratory system and reduce the effectiveness of prone position ventilation. Therefore, it is advisable to avoid drinking and smoking as much as possible.
（3） Avoid mattresses that are too soft or too hard
Sleeping on a mattress that is too soft or too hard can cause uneven pressure on the body and increase the burden on the spine. Therefore, one should choose a mattress that suits oneself to ensure the quality of sleep.
（4） Caution should be exercised for individuals with respiratory diseases, such as asthma, sleep apnea syndrome, etc. Prone ventilation may worsen the condition. Therefore, these individuals should consult a doctor's opinion before using prone position ventilation.