Kumaresan A, et al. - In patients undergoing spine surgery during general anesthesia and neuromuscular blockade, researchers determined impacts of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby examining the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. Movement from supine to the prone position was accompanied by decreases in end-expiratory esophageal pressure and increase in end-expiratory transpulmonary pressure and expiratory reserve volume. Increased chest wall elastance accounted for increased mean respiratory system driving pressure in the prone position. One mechanism for the observed clinical benefit with prone positioning may be the increase in end-expiratory transpulmonary pressure and expiratory reserve volume.