Peripheral nerve damage is a real danger of ‘proning’ in COVID-19 patients


Proning is the technique of placing a patient in a face down position to ease breathing. This method is widely used by doctors dealing with COVID-19 patients with severe respiratory distress. But a new study says that it may do more harm than good. Apparently, according to this study at the Regenerative Neurorehabilitation Laboratory at Northwestern University Feinberg School of Medicine, in Chicago, it may lead to permanent nerve damage. Also Read – Vaccines cannot be developed in a hurry: Any haste may only lead to more suffering

Researchers came to this conclusion after studying 83 COVID-19 patients who were placed face down while attached to a ventilator. On recovery, all patients were sent to a post-COVID-19 rehabilitation centre at a single health care facility. It was seen that around 14 per cent of them developed a “peripheral nerve injury” in one or more major joints. Most of the injuries were seen in the wrist, hand, foot or shoulder. But researchers say that despite this damage, proning is a potentially lifesaving intervention, which has saved a lot of lives during the pandemic. Also Read – Nasal spray COVID-19 vaccine vs injection: Which one should you opt for?

Proning may cause permanent nerve damage

According to researchers this method can sometimes irreversible nerve damage. A patient may experience loss of hand function, frozen shoulder and foot dragging. It can lead to the need for support in the form of a brace, cane or wheelchair. Researchers say that full recovery for nerve damage may occur in only about 10 per cent of patients and the recovery, if at all it takes place, will take anywhere between 12 to 24 months. This may be the longest-lasting effect of COVID-19 for patients. Also Read – ICMR says plasma therapy not beneficial, may not reduce mortality rates

Pre-existing conditions up the risk

Most of the patients who suffered from nerve damage as a result of proning were already suffering from some pre-existing conditions like diabetes, which also increases the risk of nerve injuries. Many of these patients were also either old or obese.

Inflammation may make nerves vulnerable

Experts suspect that the COVID-19 virus may make nerves more vulnerable to damage. This may be due to the increased inflammation, poor blood circulation and blood clotting. Positioning of a patient while proning and the weight it may put on certain nerves for long periods of time are also causes of this damage. But researchers say that this study was conducted only on patients on ventilators. Otherwise, it showed positive results in patients who were not on ventilator support.

Benefits of prone positioning

Although placing patients face down can cause skin pressure injuries in non-COVID-19 patients, nerve compression injuries are rare if there is regular repositioning and careful padding. It increases end-expiratory lung volume, alveolar recruitment, and oxygenation in patients with severe hypoxemic and acute respiratory failure. This is also an inexpensive therapy for the treatment of severe respiratory distress. It improves systemic oxygenation in 70 per cent to 80 per cent of patients with acute respiratory distress.

(With inputs from Agencies)

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