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Anatomical Positions

Anatomical Positions

In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...

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Lateral position during severe mono-lateral pneumonia: an experimental study.

Andrea Meli^1,2, Enric Barbeta Viñas^1,3, Denise Battaglini^1,4

¹Department of Pulmonology, Hospital Clínic of Barcelona, Barcelona, Spain.

Scientific Reports

|November 10, 2020

Summary

In unilateral pneumonia, positioning patients with the healthy lung down improved oxygenation but caused lung collapse. The diseased lung also worsened when placed down, raising concerns for this intervention.

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Area of Science:

Pulmonary Medicine
Critical Care Medicine
Respiratory Physiology

Background:

Lateral decubitus positioning is used for unilateral pneumonia to improve ventilation-perfusion.
The impact on dependent lung recruitment and oxygenation is not fully understood.
This maneuver's effect on lung collapse in unilateral pneumonia requires further investigation.

Purpose of the Study:

To evaluate the effects of lateral decubitus positioning on lung ultrasound score (LUS) and oxygenation in an animal model of unilateral pneumonia.
To assess the impact of dependent vs. non-dependent positioning of healthy and infected lungs.
To investigate lung recruitment and derecruitment in response to lateral positioning.

Main Methods:

An animal model of unilateral pneumonia was established in pigs using Pseudomonas aeruginosa.
Animals were mechanically ventilated and positioned in left-lateral or right-lateral decubitus for 3 hours.
Lung ultrasound score (LUS) and arterial blood gases (PaO2/FiO2) were measured to assess lung condition and oxygenation.

Main Results:

Left-lateral decubitus worsened the LUS of the healthy, dependent left lung (p=0.005).
The infected right lung showed improved LUS when positioned upward but worsened when dependent (p<0.001).
Oxygenation (PaO2/FiO2) improved in the left-lateral position (p=0.005), despite healthy lung collapse.

Conclusions:

In unilateral pneumonia, left-lateral decubitus improves oxygenation but leads to healthy lung collapse.
Positioning the diseased lung downward exacerbates its condition.
Clinical use of lateral decubitus in unilateral pneumonia warrants caution due to potential adverse effects on lung mechanics and oxygenation.