The heart, the lungs, and proning patients

Proning….what’s the interaction of the heart and lungs?

The heart and lung during the prone position

  • Oxygenation is improved by:
    • restoring ventilation to dorsal lung without markedly compromising ventral regions
    • altering ventilation and perfusion relationships
    • prone positioning
  • Prone positioning eliminates the compressive force of the heart on dorsal lung regions and redirects it to only a small portion of the ventral lung regions and this change:
    1. lowers the inspiratory pressure required to obtain maximal air-space recruitment (i.e., alveolar recruitment and/or airway opening)
    2. lowers the end-expiratory pressure required to maintain maximal air-space recruitment
    3. reduces cyclical air-space opening and closing.


Albert, Richard K., and Rolf D. Hubmayr. “The prone position eliminates compression of the lungs by the heart.” American journal of respiratory and critical care medicine 161.5 (2000): 1660-1665.


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