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. 1979 Aug;34(4):518–522. doi: 10.1136/thx.34.4.518

Effect of body position on gas exchange after thoracotomy.

D Seaton, N L Lapp, W K Morgan
PMCID: PMC471108  PMID: 505348

Abstract

To determine the effect of change in body position on gas exchange after thoracotomy, 12 patients with potentially resectable lung tumours were studied before and 24 hours after operation. Measurements of arterial blood gas tension (PaO2, PaCO2), alveolar-arterial oxygen difference (A--adO2), venous admixture effect (Qs/Qt percent), and physiological dead space to tidal volume ratio (Vd/Vt), were made in the supine, and left and right lateral decubitus positions. Preoperatively, altering position did not affect gas exchange significantly. After thoracotomy in the lateral position with the unoperated side dependent, PaO2 was significantly higher, and A--adO2 and Qs/Qt percent significantly lower than in the supine position. Postoperatively, the lateral position with the side of thoracotomy dependent was usually associated with the worst gas exchange. Only three patients achieved their best postoperative gas exchange in this position. In two this may have resulted from dependent small airway closure during tidal breathing, due to airways obstruction and old age, and in the third from postoperative atelectasis in this unoperated lung. No significant changes in mean PaCO2, Vd/Vt, or minute ventilation (VE) occurred with different positioning.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arborelius M., Jr, Granqvist U., Lilja B., Zauner C. W. Regional lung function and central haemodynamics in the right lateral body position during hypoxia and hyperoxia. Respiration. 1974;31(3):193–200. doi: 10.1159/000193109. [DOI] [PubMed] [Google Scholar]
  2. BLAIR E., HICKAM J. B. The effect of change in body position on lung volume and intrapulmonary gas mixing in normal subjects. J Clin Invest. 1955 Mar;34(3):383–389. doi: 10.1172/JCI103086. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BRYAN A. C., BENTIVOGLIO L. G., BEEREL F., MACLEISH H., ZIDULKA A., BATES D. V. FACTORS AFFECTING REGIONAL DISTRIBUTION OF VENTILATION AND PERFUSION IN THE LUNG. J Appl Physiol. 1964 May;19:395–402. doi: 10.1152/jappl.1964.19.3.395. [DOI] [PubMed] [Google Scholar]
  4. COLE R. B., BISHOP J. M. EFFECT OF VARYING INSPIRED O2 TENSION ON ALVEOLAR-ARTERIAL O2 TENSION DIFFERENCE IN MAN. J Appl Physiol. 1963 Nov;18:1043–1048. doi: 10.1152/jappl.1963.18.6.1043. [DOI] [PubMed] [Google Scholar]
  5. Gaensler E. A., Wright G. W. Evaluation of respiratory impairment. Arch Environ Health. 1966 Feb;12(2):146–189. doi: 10.1080/00039896.1966.10664355. [DOI] [PubMed] [Google Scholar]
  6. INADA K., KISHIMOTO S., SATO A., WATANABE T. Bronchospirometry with the Carlens double lumen catheter; evaluation and exercise test. J Thorac Surg. 1954 Feb;27(2):173–186. [PubMed] [Google Scholar]
  7. Kaneko K., Milic-Emili J., Dolovich M. B., Dawson A., Bates D. V. Regional distribution of ventilation and perfusion as a function of body position. J Appl Physiol. 1966 May;21(3):767–777. doi: 10.1152/jappl.1966.21.3.767. [DOI] [PubMed] [Google Scholar]
  8. Leblanc P., Ruff F., Milic-Emili J. Effects of age and body position on "airway closure" in man. J Appl Physiol. 1970 Apr;28(4):448–451. doi: 10.1152/jappl.1970.28.4.448. [DOI] [PubMed] [Google Scholar]
  9. McCarthy D. S., Spencer R., Greene R., Milic-Emili J. Measurement of "closing volume" as a simple and sensitive test for early detection of small airway disease. Am J Med. 1972 Jun;52(6):747–753. doi: 10.1016/0002-9343(72)90080-0. [DOI] [PubMed] [Google Scholar]
  10. SEVERINGHAUS J. W. Oxyhemoglobin dissociation curve correction for temperature and pH variation in human blood. J Appl Physiol. 1958 May;12(3):485–486. doi: 10.1152/jappl.1958.12.3.485. [DOI] [PubMed] [Google Scholar]
  11. WEST J. B., DOLLERY C. T. Distribution of blood flow and ventilation-perfusion ratio in the lung, measured with radioactive carbon dioxide. J Appl Physiol. 1960 May;15:405–410. doi: 10.1152/jappl.1960.15.3.405. [DOI] [PubMed] [Google Scholar]
  12. Zack M. B., Pontoppidan H., Kazemi H. The effect of lateral positions on gas exchange in pulmonary disease. A prospective evaluation. Am Rev Respir Dis. 1974 Jul;110(1):49–55. doi: 10.1164/arrd.1974.110.1.49. [DOI] [PubMed] [Google Scholar]

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