• Improved V/Q matching (probably most important factor)
    • More uniform distribution of ventilation and perfusion
    • Prevents atelectatic bases receiving highest blood flow
  • A relative increase in functional residual capacity
    • Reduction of cephalad pressure on the diaphragm
    • Reopening of atelectatic segments
  • More homogeneous ventilation:
    • Reduces the difference between the dorsal and ventral pleural pressure
    • Protective against ventilator-associated lung injury – less cyclical atelectasis and alveolar overdistension
  • Less lung deformation
    • Less compression of the lungs by the heart (which sits on the sternum in the prone position)
    • Less compression by the abdominal content. ·
  • Improved drainage of secretions:
    • The orientation of large airways apparently enhances the drainage of respiratory secretions and aspirated material
  • Improved mechanics of the chest wall in obesity