Patient positioning with lung injury

[roast]

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I understand good lung down for pneumonia but can someone explain to me why if you have a TB lesion that is causing bleeding and massive hemoptysis you would want to place the patient with that lung down to "preserve gas exchange in the non bleeding lung." I am referring to uworld question 4937 to be exact. Only thing i can think of is that if the bleeding side was up then some of that blood could enter the opposite side and now hinder gas exchange in both lungs. Is this a correct assumption? Any help would be greatly appreciated. Thanks!

 

[gravitywave]

Yup. Massive hemoptysis will flood both lungs if you don't take gravity out of the equation by putting the bad side down.

 

[cbcb00]

Yup it's the gravity issue. Blood and secretions that could flow down are the exceptions to the "good lung down" rule for max gas exchange.