38 Cytokine Serum Levels and Whole Blood Superoxide Anion Generation in Mothers and Newborns During Peripartum

Abstract

Background: Nursing of preterm infants in head elevatedprone position (HEPP) has been proposed to reduce a p n e a s without controlled clinical trial up to now. Objective: To investigate the effect of HEPPcompared with horizontal prone position on the incidence of apneas. Design: Randomized, controlled, cross-over trial. Patients: 2 0 spontaneously breathing preterm infants with apneas: 26-31 gestational weeks. birth weight 730-1680 g, postnatal a g e 2-49 d. 1 5 infants treated with aminophylline (serum concentration 44-81 pmol/l). Intervention: Each infant was nursed in prone position in a n incubator and spent a total of 2 4 hours in horizontal position and a total of 2 4 hours in H E P P (159. Position was changed every 6 hours in random order. Outcome measures: Number of apneas (absence of breathing movements for > I 0 s by thoracic impedance). Number of severe a p n e a s >20 s and hypoxemia (arterial saturation by pulse oximetry < 85%) or bradycardia (<90 bpm). Results: There were 24% less apneas in HEPPcompared with horizontal position (mean difference 16 a p n e a s / 24 h, 95%CI 5-27). Severe a p n e a s were reduced by 21% in H E P P (mean difference 9 apneas / 24 hrs, 95%C13-15). Conclusion: Nurs~ng in head up till posilion (15" reduces central a p n e a s in preterm infants.