When positioning a patient with unilateral lung disease for ventilation, which is recommended?

• A. Position the good lung down.
• B. Position the affected lung down.
• C. Position on the back with head elevated.
• D. Position the patient prone.

Answer: (A)

In unilateral lung disease, the goal is to maximize oxygenation by aligning blood flow with the lung that can best exchange gases. Placing the good, well-ventilated lung in the dependent position uses gravity to increase perfusion to that lung, improving ventilation-perfusion matching and overall oxygenation. If the diseased lung were down, more blood would flow through tissue that isn’t capable of efficient gas exchange, worsening oxygenation. Other positions don’t optimize this perfusion-to-ventilation relationship as effectively, so the recommended choice is to have the healthy lung down.