Positional Therapy of Unilateral Lung Disease
It is known that gravity affects pulmonary gas exchange and that in adults both ventilation and perfusion are better in the dependent lung. In infants, the reverse is true. Ventilation lung scans using krypton-81m demonstrate that the mean fractional ventilation in one lung may be 30% different from the other, depending on whether it is dependent or uppermost. This pattern is seen in both diseased and normal lungs.
The clinical importance of this observation relates to therapy of infants with unilateral lung disease, whose respiratory function is significantly compromised. Positioning of such infants with the normal lung uppermost will improve gas exchange.
Infants with impaired respiratory function secondary to congenital diaphragmatic hernia, hypoplastic lung, and unilateral atelectasis or pneumonia may benefit from such positioning.
