Abstract
The spread of COVID-19 has been exponential throughout the globe. Though only a small percentage of infected individuals reach the critical stage of the disease, i.e., acute respiratory distress syndrome (ARDS), this percentage represents a significant number of patients that can overwhelm the healthcare system. Patients presenting with ARDS need mechanical ventilation, as their lungs are unable to oxygenate blood on their own due to fluid accumulation. One way to manage this excess pressure of fluid build-up around the lung tissues is to relieve the dorsal alveoli by prompting the patient to lie face down on the stomach; this is called awake proning. It is a procedure that is directed towards the recruitment of lung parenchyma when infected with pneumonia or when the condition has worsened into ARDS. This helps in relieving the pressure from the dorsal lung surface that has markedly higher perfusion than the ventral surface. Awake proning delays the use of mechanical ventilation and facilitates the patients with severe ARDS or severe pneumonia in maintaining the supply of oxygen to the body tissues. Since medical institutes are overburdened and limited ventilators are available, awake proning can reduce not only the burden on hospitals but also decrease the need for ventilators.
Highlights
BackgroundCOVID-19 is a respiratory viral illness that is responsible for taking the lives of more than 8,064,000 people all around the world as of June 15, 2020
A COVID-19 patient presenting with severe pneumonia or acute respiratory distress syndrome (ARDS) can be managed with awake proning as a supportive treatment to relieve symptoms
Awake proning helps in improving oxygenation by the optimization of the lung parenchyma and the recruitment of the alveoli along the dorsal surface with higher perfusion, better ventilation is provided to the body
Summary
COVID-19 is a respiratory viral illness that is responsible for taking the lives of more than 8,064,000 people all around the world as of June 15, 2020. It is caused by a novel coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [2] The illness that it causes starts with mild symptoms like fever, dry cough, and sore throat and, in several people, with a recent loss in the senses of smell (anosmia) and taste (ageusia) [3,4]. As it progresses, the disease presents with more severe symptoms like viral pneumonia, which causes acute respiratory distress syndrome (ARDS). Neutrophils release the molecules that are cytotoxic in nature, like enzymes, bioactive lipids, cytokines, and reactive oxygen species These molecules, when released in excess, are responsible for cell necrosis and tissue damage. Table1lists the biomarkers of ARDS that can be identified in serum [9]
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