{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:40:49Z","timestamp":1761846049812,"version":"build-2065373602"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006162","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Ci\u00c3\u00aancia e Tecnologia do Estado de Pernambuco","doi-asserted-by":"publisher","award":["IBPG-1976\/4.08\/22"],"award-info":[{"award-number":["IBPG-1976\/4.08\/22"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006162","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Ci\u00c3\u00aancia e Tecnologia do Estado de Pernambuco","doi-asserted-by":"publisher","award":["APQ -0249-4.08\/20"],"award-info":[{"award-number":["APQ -0249-4.08\/20"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00c3fico e Tecnol\u00c3\u00b3gico","doi-asserted-by":"publisher","award":["APQ 306240\/2021-1"],"award-info":[{"award-number":["APQ 306240\/2021-1"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006162","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Ci\u00c3\u00aancia e Tecnologia do Estado de Pernambuco","doi-asserted-by":"publisher","award":["IBPG-0398- 2.12\/23"],"award-info":[{"award-number":["IBPG-0398- 2.12\/23"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lateral positioning improves pulmonary mechanics and lung volumes, but its effects in healthy adults remain unclear due to individual variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze the acute effects of lateral body positioning on regional lung ventilation and lung volumes in healthy adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This within-subject study included two protocols: supine and left-lateral position (unilateral) with repeated measures and supine, left, and right-lateral positions (bilateral). All positions were performed at 30\u00b0 for 5 minutes on an automated rotation bed. Electrical Impedance Tomography measured regional lung ventilation (%) and end-expiratory lung volumes (EELV) across four lung regions: (anterior right [AR] and left [AL]; posterior right [PR], and left [PL]). Linear mixed models assessed the influence of body position and individual variability on regional ventilation and lung volumes, while the Restricted Maximum Likelihood method compared between right- and left-lateral positioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the unilateral protocol (n\u2009=\u200929; 58.6% male; 22.8\u2009\u00b1\u20094.0 years), left-lateral positioning decreased regional ventilation in nondependent regions (AR: \u22120.96%, PR: \u22121.63%) and increased it in dependent regions (PL: 1.17%, AL: 1.42%) versus supine (p\u2009&lt;\u20090.001). EELV increased in PL (+ 0.7\u2009mL\/kg PBW), PR (+2.0), and AR (+2.8), but decreased in AL (\u22122.3) (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:italic>\n                      \u2009&lt;\u20090.001). In the bilateral protocol (n\u2009=\u200910, 70% male; 23.6\u2009\u00b1\u20093.2 years), regional ventilation showed no significant effects of position, ROI, or interaction (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:italic>\n                      \u2009&gt;\u20090.05). However, EELV varied significantly with body position (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:italic>\n                      \u2009&lt;\u20090.001), with no isolated ROI effect (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                      <\/jats:italic>\n                      \u2009=\u20091.000).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lateral positioning improves regional ventilation in dependent lung regions and increases EELV in nondependent and posterior dependent lung regions, regardless of side.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec006\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov [\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT06044896\" xlink:type=\"simple\">NCT06044896<\/jats:ext-link>\n                      ]\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0335622","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:36:47Z","timestamp":1761845807000},"page":"e0335622","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiology of body lateralization on regional lung ventilation and lung volumes in healthy subjects: Within-subjects design"],"prefix":"10.1371","volume":"20","author":[{"given":"Layane S. P.","family":"Costa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyda M. A.","family":"Reinaux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8596-580X","authenticated-orcid":true,"given":"Emanuel F. F. Silva","family":"J\u00fanior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5716-125X","authenticated-orcid":true,"given":"Wagner S.","family":"Leite","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniella C.","family":"Brand\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arm\u00e8le Dornelas","family":"de Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1503-3994","authenticated-orcid":true,"given":"Rollin","family":"Rold\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caio C. A.","family":"Morais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3079-8300","authenticated-orcid":true,"given":"Shirley Lima","family":"Campos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"issue":"1","key":"pone.0335622.ref001","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40560-022-00600-z","article-title":"Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis","volume":"10","author":"DP Pozuelo-Carrascosa","year":"2022","journal-title":"J Intensive Care"},{"issue":"3","key":"pone.0335622.ref002","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1152\/jappl.1966.21.3.778","article-title":"Effect of gravity on the distribution of pulmonary ventilation","volume":"21","author":"AC Bryan","year":"1966","journal-title":"J Appl Physiol"},{"issue":"2","key":"pone.0335622.ref003","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/0034-5687(70)90016-2","article-title":"Topography of the pleural pressure in rabbits and dogs","volume":"8","author":"E D\u2019Angelo","year":"1970","journal-title":"Respir Physiol"},{"key":"pone.0335622.ref004","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1152\/jappl.1964.19.4.713","article-title":"Distribution of blood flow in isolated lung; relation to vascular and alveolar pressures","volume":"19","author":"JB West","year":"1964","journal-title":"J Appl Physiol"},{"issue":"4","key":"pone.0335622.ref005","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1183\/09031936.00037014","article-title":"Gas exchange and ventilation-perfusion relationships in the lung","volume":"44","author":"J Petersson","year":"2014","journal-title":"Eur Respir J"},{"issue":"3","key":"pone.0335622.ref006","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1152\/jappl.1966.21.3.749","article-title":"Regional distribution of inspired gas in the lung","volume":"21","author":"J Milic-Emili","year":"1966","journal-title":"J Appl Physiol"},{"issue":"12","key":"pone.0335622.ref007","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.4187\/respcare.11781","article-title":"Effect of continuous lateral rotation therapy on clinical outcomes in mechanically ventilated critically ill adults","volume":"69","author":"ALA Brito","year":"2024","journal-title":"Respir Care"},{"issue":"5","key":"pone.0335622.ref008","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1152\/jappl.1967.23.5.694","article-title":"Vertical gradient of alveolar size in lungs of dogs frozen intact","volume":"23","author":"JB Glazier","year":"1967","journal-title":"J Appl Physiol"},{"issue":"4","key":"pone.0335622.ref009","first-page":"426","article-title":"Regional differences in the lung","volume":"74","author":"JB West","year":"1978","journal-title":"Chest"},{"key":"pone.0335622.ref010","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"TC Hoffmann","year":"2014","journal-title":"BMJ"},{"issue":"5","key":"pone.0335622.ref011","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1590\/bjpt-rbf.2014.0044","article-title":"Predictive equations for respiratory muscle strength according to international and Brazilian guidelines","volume":"18","author":"IMBS Pessoa","year":"2014","journal-title":"Braz J Phys Ther"},{"issue":"8","key":"pone.0335622.ref012","doi-asserted-by":"crossref","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement","volume":"200","author":"BL Graham","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"pone.0335622.ref013","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1097\/ALN.0000000000004613","article-title":"Lung Imaging Acquisition with Electrical Impedance Tomography: Tackling Common Pitfalls","volume":"139","author":"R Ribeiro De Santis Santiago","year":"2023","journal-title":"Anesthesiology"},{"issue":"1","key":"pone.0335622.ref014","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1136\/thoraxjnl-2016-208357","article-title":"Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group","volume":"72","author":"I Frerichs","year":"2017","journal-title":"Thorax"},{"issue":"1","key":"pone.0335622.ref015","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1186\/s13054-024-05173-x","article-title":"Electrical impedance tomography monitoring in adult ICU patients: state-of-the-art, recommendations for standardized acquisition, processing, and clinical use, and future directions","volume":"28","author":"G Scaramuzzo","year":"2024","journal-title":"Crit Care"},{"issue":"1","key":"pone.0335622.ref016","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1186\/s13054-018-2195-6","article-title":"Electrical impedance tomography in acute respiratory distress syndrome","volume":"22","author":"MC Bachmann","year":"2018","journal-title":"Crit Care"},{"issue":"18","key":"pone.0335622.ref017","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1056\/NEJM200005043421801","article-title":"Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome","volume":"342","author":"Network Acute Respiratory Distress Syndrome","year":"2000","journal-title":"N Engl J Med"},{"issue":"10","key":"pone.0335622.ref018","doi-asserted-by":"crossref","DOI":"10.1088\/1361-6579\/ad7f1f","article-title":"Physiological definition for region of interest selection in electrical impedance tomography data: description and validation of a novel method","volume":"45","author":"JE Francovich","year":"2024","journal-title":"Physiol Meas"},{"key":"pone.0335622.ref019","unstructured":"Schoenfeld DA. Statistical considerations for clinical trials and scientific experiments. 2023. https:\/\/hedwig.mgh.harvard.edu\/sample_size\/size.html"},{"issue":"1","key":"pone.0335622.ref020","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1186\/s12890-022-02276-5","article-title":"The effect of posture on airflow distribution, airway geometry and air velocity in healthy subjects","volume":"22","author":"KM Ides","year":"2022","journal-title":"BMC Pulm Med"},{"issue":"1","key":"pone.0335622.ref021","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12890-021-01501-x","article-title":"Targeted lateral positioning decreases lung collapse and overdistension in COVID-19-associated ARDS","volume":"21","author":"M Ml\u010dek","year":"2021","journal-title":"BMC Pulm Med"},{"issue":"1","key":"pone.0335622.ref022","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13613-022-00988-9","article-title":"Sequential lateral positioning as a new lung recruitment maneuver: an exploratory study in early mechanically ventilated Covid-19 ARDS patients","volume":"12","author":"R Rold\u00e1n","year":"2022","journal-title":"Ann Intensive Care"},{"issue":"2","key":"pone.0335622.ref023","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/0034-5687(75)90057-2","article-title":"Vertical gradients of pleural and transpulmonary pressure with liquid-filled lungs","volume":"23","author":"E D\u2019Angelo","year":"1975","journal-title":"Respir Physiol"},{"issue":"2","key":"pone.0335622.ref024","first-page":"83","article-title":"Redistribution of blood flow and lung volume between lungs in lateral decubitus postures during unilateral atelectasis and PEEP","volume":"49","author":"H Chang","year":"2006","journal-title":"Chin J Physiol"},{"issue":"1","key":"pone.0335622.ref025","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1152\/jappl.2001.91.1.39","article-title":"Gravity effects on regional lung ventilation determined by functional EIT during parabolic flights","volume":"91","author":"I Frerichs","year":"2001","journal-title":"J Appl Physiol (1985)"},{"issue":"19","key":"pone.0335622.ref026","doi-asserted-by":"crossref","first-page":"384","DOI":"10.21037\/atm.2018.05.50","article-title":"Effects of patient positioning on respiratory mechanics in mechanically ventilated ICU patients","volume":"6","author":"M Mezidi","year":"2018","journal-title":"Ann Transl Med"},{"key":"pone.0335622.ref027","doi-asserted-by":"crossref","first-page":"1113568","DOI":"10.3389\/fphys.2023.1113568","article-title":"Real-time effects of lateral positioning on regional ventilation and perfusion in an experimental model of acute respiratory distress syndrome","volume":"14","author":"M Ml\u010dek","year":"2023","journal-title":"Front Physiol"},{"key":"pone.0335622.ref028","doi-asserted-by":"crossref","first-page":"103952","DOI":"10.1016\/j.iccn.2025.103952","article-title":"Effects of routine postural repositioning on the distribution of lung ventilation and perfusion in mechanically ventilated patients","volume":"87","author":"MDR Huerta","year":"2025","journal-title":"Intensive Crit Care Nurs"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0335622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:36:54Z","timestamp":1761845814000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0335622"}},"subtitle":[],"editor":[{"given":"Roberta","family":"Ribeiro De Santis Santiago","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":28,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0335622","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]}}}