Effects of supine and lateral positions on cardiac output and intracardiac pressures: an experimental study

Hemodynamic measurements in human subjects and in experimental animals are generally made in the supine position; not much attention is paid to potential beneficial or harmful effects of right or left lateral positions on cardiac output or other hemodynamic variables. To evaluate the potential influence of such positional changes on cardiac performance, we measured cardiac output and left and right ventricular pressures (with micromanometer catheters) in anesthetized experimental animals (eight dogs and nine pigs) in the supine, right lateral, and left lateral positions. Cardiac output increased from supine to left lateral (mean +/- SD, 2.6 +/- 0.9 to 3.1 +/- 1.0 liters/min; p less than .001) and from supine to right lateral positions (2.6 +/- 0.9 to 3.1 +/- 1.1 liters/min; p less than .001). There was an associated decrease in arteriovenous oxygen saturation difference from supine to left lateral position (31 +/- 8% to 24 +/- 4%; p less than .001) and from supine to right lateral position (32 +/- 9% to 25 +/- 6%; p less than .001). Left ventricular systolic and end-diastolic pressures increased from supine to left lateral (128 +/- 17/9 +/- 2 to 147 +/- 19/16 +/- 4 mm Hg; both p less than .001) and from supine to right lateral positions (128 +/- 19/9 +/- 2 to 141 +/- 16/16 +/- 7 mm Hg; p less than .01 and p less than .001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)