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. 2022 Dec 15;22(1):477.
doi: 10.1186/s12890-022-02276-5.

The effect of posture on airflow distribution, airway geometry and air velocity in healthy subjects

Kris M Ides  1   2   3   4 , Wilfried A De Backer  5   6 , Maarten Lanclus  7 , Glenn Leemans  5 , Wendel Dierckx  5   6 , Eline Lauwers  8   9   10 , Dirk Vissers  5 , Jan Steckel  11 , Jan W De Backer  7
Affiliations

The effect of posture on airflow distribution, airway geometry and air velocity in healthy subjects

Kris M Ides et al. BMC Pulm Med. .

Abstract

Background: Gravity, and thus body position, can affect the regional distribution of lung ventilation and blood flow. Therefore, body positioning is a potential tool to improve regional ventilation, thereby possibly enhancing the effect of respiratory physiotherapy interventions. In this proof-of-concept study, functional respiratory imaging (FRI) was used to objectively assess effects of body position on regional airflow distribution in the lungs.

Methods: Five healthy volunteers were recruited. The participants were asked during FRI first to lie in supine position, afterwards in standardized right lateral position.

Results: In right lateral position there was significantly more regional ventilation also described as Imaging Airflow Distribution in the right lung than in the left lung (P < 0.001). Air velocity was significantly higher in the left lung (P < 0.05). In right lateral position there was significantly more airflow distribution in the right lung than in the left lung (P < 0.001). Significant changes were observed in airway geometry resulting in a decrease in imaged airway volume (P = 0.024) and a higher imaged airway resistance (P = 0.029) in the dependent lung. In general, the effect of right lateral position caused a significant increase in regional ventilation (P < 0.001) in the dependent lung when compared with the supine position.

Conclusions: Changing body position leads to significant changes in regional lung ventilation, objectively assessed by FRI The volume based on the imaging parameters in the dependent lung is smaller in the lateral position than in the supine position. In right lateral decubitus position, airflow distribution is greater in dependent lung compared to the nondependent lung.

Trial registration: The trial has been submitted to www.

Clinicaltrials: gov with identification number NCT01893697 on 07/02/2013.

Keywords: Airway clearance; Internal airflow distribution; Posture; Respiratory physiology; Ventilation.

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Conflict of interest statement

JDB and WDB are shareholders/board member of FLUIDDA NV, a company that commercializes some of the techniques used in this manuscript. EL is employed by FLUIDDA NV. ML is employed by FLUIDDA Inc. The other authors (GL, KI, DV, JS, WD) have no conflict of interest relevant to this article.

Figures

Fig. 1
Fig. 1
Effect of the right lateral position on regional ventilation (IAD) compared with a supine position for the right and left lung
Fig. 2
Fig. 2
Effect of the right lateral position on airway geometry (iRaw–iVaw) compared with a supine position for the right and left lung
Fig. 3
Fig. 3
Effect of the right lateral position on air velocity compared with a supine position for the right and left lung
Fig. 4
Fig. 4
Effect of the right lateral position on Lobar volumes (Vlobe) on Functional residual capacity (FRC) and Total lung capacity (TLC) compared with a supine position for the right and left lung
Fig. 5
Fig. 5
Regional ventilation maps for a healthy subject in supine (A) and right lateral position (B), as well as the relative effect between both. substantial relative ventilation defect can be seen in the left lung as a result of the right lateral position, with regional effect values up to 25. Ventilation maps are CT based representations of regional ventilation, derived from pulmonary CT images acquired at two different inflation levels, functional residual capacity (FRC) and total lung capacity (TLC) without the use of exogenous contrast, by assuming that regional changes in lung volume relate to regional ventilation The Jacobian determinant of the deformation field from FRC to TLC is calculated, which measures the differential expansion of the image
See this image and copyright information in PMC

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