What is the role of lateral decubitus positioning in the treatment of pulmonary interstitial emphysema (PIE)?

Updated: Jun 25, 2019
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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Lateral decubitus positioning is a conservative approach that has been used successfully in infants with pulmonary interstitial emphysema (PIE), and it is most effective in infants with unilateral PIE. In different case studies of lateral decubitus positioning as a treatment of unilateral PIE in infants, PIE resolved in 48 hours to 6 days with minimal recurrence and a low failure rate. Thus, lateral decubitus positioning should be considered as an early first-line therapy in the management of unilateral PIE; it has also been used successfully for patients with bilateral PIE when one side is more significantly affected.

Place the infant in the lateral decubitus position, with the affected lung dependent. This therapy can result in plugging of dependent airways and improved oxygenation of the nondependent lung. The latter allows for an overall decrease in ventilatory settings. The combination of the above factors helps in resolving PIE. [31]

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