Pulmonary perfusion in the prone and supine postures in the normal human lung

G. Kim Prisk, Kei Yamada, A. Cortney Henderson, Tatsuya J. Arai, David L. Levin, Richard B. Buxton, Susan R. Hopkins

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Prone posture increases cardiac output and improves pulmonary gas exchange. We hypothesized that, in the supine posture, greater compression of dependent lung limits regional blood flow. To test this, MRI-based measures of regional lung density, MRI arterial spin labeling quantification of pulmonary perfusion, and density-normalized perfusion were made in six healthy subjects. Measurements were made in both the prone and supine posture at functional residual capacity. Data were acquired in three nonoverlapping 15-mm sagittal slices covering most of the right lung: central, middle, and lateral, which were further divided into vertical zones: anterior, intermediate, and posterior. The density of the entire lung was not different between prone and supine, but the increase in lung density in the anterior lung with prone posture was less than the decrease in the posterior lung (change: +0.07 g/cm3 anterior, -0.11 posterior; P < 0.0001), indicating greater compression of dependent lung in supine posture, principally in the central lung slice (P < 0.0001). Overall, density-normalized perfusion was significantly greater in prone posture (7.9 ± 3.6 ml·min-1·g-1 prone, 5.1 ± 1.8 supine, a 55% increase; P < 0.05) and showed the largest increase in the posterior lung as it became nondependent (change: +71% posterior, +58% intermediate, +31% anterior; P = 0.08), most marked in the central lung slice (P < 0.05). These data indicate that central posterior portions of the lung are more compressed in the supine posture, likely by the heart and adjacent structures, than are central anterior portions in the prone and that this limits regional perfusion in the supine posture.

Original languageEnglish (US)
Pages (from-to)883-894
Number of pages12
JournalJournal of applied physiology
Volume103
Issue number3
DOIs
StatePublished - Sep 2007

Keywords

  • Gas exchange
  • Gravity
  • Lung density
  • Magnetic resonance imaging
  • Prone
  • Supine

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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    Prisk, G. K., Yamada, K., Henderson, A. C., Arai, T. J., Levin, D. L., Buxton, R. B., & Hopkins, S. R. (2007). Pulmonary perfusion in the prone and supine postures in the normal human lung. Journal of applied physiology, 103(3), 883-894. https://doi.org/10.1152/japplphysiol.00292.2007