Pneumonia and side-sleeping

[Diesel10]

If a patient has a unilateral lobar pneumonia, what side do you tell them to sleep on? I remember having a q about this awhile back but I can't remember what the answer was. Do you tell them to sleep on the affected side (increasing blood flow to the affected lung I'm assuming would help clear the infection more efficiently?) or do you tell them to sleep on the unaffected side (in order to maximize blood flow to the better-ventilated, i.e., healthy, lung)?

Any advice or insight would be much appreciated.

Thanks!

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[Boardz]

If a patient has a unilateral lobar pneumonia, what side do you tell them to sleep on? I remember having a q about this awhile back but I can't remember what the answer was. Do you tell them to sleep on the affected side (increasing blood flow to the affected lung I'm assuming would help clear the infection more efficiently?) or do you tell them to sleep on the unaffected side (in order to maximize blood flow to the better-ventilated, i.e., healthy, lung)?

Any advice or insight would be much appreciated.

Thanks!

the answer was probably treat the underlying condition.

seriously, a wtf question by my lights.

But i would guess, tell them to sleep on the unaffected side. The lung with the lobar pneumonia probably has 1) decreased PAO2, PaO2 as well as 2) decreased blood flow.

1- from the exudate and consolidation. tough place for o2 diffusion to happen. and as a result -->
2. hypoxemia induced vasoconstriction.

So, in that lung you don't have much going for you (that laying on one side or the other will help). So, if you're having trouble perfusing your organs or whatever, use the lung that work.

oh, that reminds me. A healthy lung is perfusion limited which means that the limiting factor is the amount of blood flowing through the lungs as opposed to the rate of oxygen diffusing across the alveolar/capillary interface. So, if you increase blood flow by laying on the unaffected side, you can increase the oxygen content in your body.