Is Proning Helpful For Reaspiratory Disease? || Breathing Exercise ||COVID-19|| Nasren Nipa

Is Proning Helpful For Reaspiratory Disease

What is Proning? : 

Deep breathing occurs when your back is on top and your chest is below.This is called prone positioning.

Advantage of Proning:

The main physiological aims of prone positioning are: 

1) to improve oxygenation; 

2) to improve respiratory mechanics; 

3) to homogenise the pleural pressure gradient, the alveolar inflation and the ventilation distribution; 

4) to increase lung volume and reduce the amount of atelectatic regions; 

5) to facilitate the drainage of secretions; and 

6) to reduce ventilator-associated lung injury.

Who get Benifitted from Proning?:

-Proning is helpful for almost all person.

- Prone Positioning is useful for the treatment of acute respiratory distress syndrome (ARDS).

- Patients with coronavirus disease 19 (COVID-19) develop severe respiratory failure and require mechanical ventilation, most often fulfilling criteria for acute respiratory distress syndrome.

- Acute respiratory distress syndrome (ARDS) is characterised by radiographical diffuse bilateral infiltrates, decreased respiratory compliance, small lung volumes and severe hypoxaemia. Correction of life-threatening hypoxia and improvement of respiratory mechanics and lung volumes are the main treatment goals. To achieve these ends, it is important to select the most appropriate means of ventilatory support, thereby minimising the damaging effects of mechanical ventilation.

Who should not do Proning :

Absolute contraindications to prone ventilation include 

-spinal instability,

-patients at risk of spinal instability (eg, rheumatoid arthritis),

-unstable fractures (especially facial and pelvic),

-anterior burns,

-chest tubes, and 

-pregnancy,

-recent tracheal surgery, and 

-raised intracranial pressure .

Procedure of Proning :

1.Begin by lying on your stomach with one or two pillows under your hips and a pillow or folded towel under your head. Maintain this position while breathing evenly. Perform for 30 minutes (up to 2 hours) at a time.

2.Lie on the right side for the next 30 minutes to 2 hours (keep the bed level).

3.For the next 30 minutes to 2 hours, adjust the side of the bed and lie down at 30-60 degrees (keep the bed level).

4.Lie on the left side for the next thirty minutes to two hours (keep the bed level).

5.From the next 30 minutes to 2 hours, be completely upside down and return to your previous position (keep the bed level).

   Proning can not guaratee mortality but it can improve oxygenation and gives ventilation support in patient with Respiratory disease.

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