What are the physiological benefits of awake self–prone positioning for patients with COVID-19? Should we also be using this position for awake patients who do not have COVID-19?

A Maureen A. Seckel, MSN, APRN, ACNS-BC, CCNS, CCRN, replies:

Some similarities exist between the use of prone positioning for patients with acute respiratory distress syndrome (ARDS) and awake self–prone positioning (ASPP) for patients with COVID-19. These parallels can help us understand both treatment modalities.

Use of the prone position to improve pulmonary mechanics during mechanical ventilation has been described in the literature for more than 50 years.1–3  Numerous guidelines strongly recommend prone positioning as a therapeutic modality for patients with ARDS receiving mechanical ventilation in the intensive care unit (ICU).4–6  During prone positioning, oxygenation seems to improve through better perfusion to the now dorsal regions; also, alveolar inflation...

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