How proning can help improving oxygen levels in Covid-19 patients

Proning exercises provide immediate benefits. (IE)

With India witnessing a surge in novel coronavirus cases, doctors are advocating proning exercises to improve oxygen levels in Covid-19 patients, both in hospital and in home isolation. Proning is a medically approved position of human body, which is also being promoted by the government. While doing this exercise, patients lie on their abdomen to boost the levels of oxygen. The proning exercises provide immediate benefits, an IE report said. An English daily recently reported how an 82-year-old Covid positive patient from Gorakhpur, improved her oxygen levels from 75 to 94 after sleeping in a prone position. In hospitals, proning is being advised to patients who are covid positive so that they may not require additional oxygen support.

Proning positions

The patient while practicing this exercise is made to lie on his/her belly using the support of pillows. The person can also lie on their right side, left side or sit at a 60 to 90 degree angle in the ‘fowler position’. It is suggested that a patient remain in prone position for a minimum of half an hour to a maximum of two hours. According to Dr Surendra Gupta, a Ludhiana-based doctor, this exercise helps improve ventilation to the lungs and thus, the levels of oxygen start improving.

How oxygen levels are improved?

Dr Gupta says that if SpO2 or oxygen saturation goes below 94, timely proning as well as maintaining good ventilation can save a human life. As per guidelines issued by the Union Ministry of Health, proning improves ventilation to the lungs, and also it keeps the alveoli units open, thereby easing breathing.

What is required for proning?

Proning needs just 4-5 pillows. One pillow is kept below the neck, one or two pillows below the chest through upper thighs, and two pillows are placed below the shins. For proning, a patient should lie on their belly, and alternately to right, left side. However, experts suggest that for best results, at least half an hour should be spent in each proned position.

When to avoid proning?

The proning exercise should not be practiced during pregnancy, or those with deep venous thrombosis (treatment provided in less than 48 hours). Proning should also be avoided by patients with major cardiac conditions, unstable spine femur or pelvic fractures, according to a help book circulated by the Ludhiana district administration for the citizens.

Do’s and don’ts while doing proning exercise

Proning should be avoided after meals for an hour atleast. A person should stay in one particular position for as much time as it is tolerable for him/her. To alter the pressure areas and comfort, pillows can be slightly adjusted. The room where proning is practiced should be well ventilated. A person should not ignore any pressure sores and injuries. According to the Health Ministry, a patient can be prone for up to 16 hours a day in multiple cycles, if it is comfortable for him/her.

Other ways to improve oxygen levels

The Health Ministry suggests that deep breathing, ample access to fresh air, yogic pranayama, eating iron-rich foods, staying hydrated and light exercises also help in improving oxygen level of patients in home isolation.