Effect of positioning on pulmonary function of newborns: Comparison of supine and prone position

Abstract

The effect of positioning on pulmonary function has been previously evaluated, and the prone position has been reported to be preferable for neonates with various respiratory diseases. Studies in healthy neonates have yielded conflicting results. Using a crying pulmonary function test, we examined the effect of positioning on pulmonary function in healthy full‐term neonates. Thirty‐nine infants with a mean birthweight (± SD) of 3,140 ± 379 g and a mean gestational age (± SD) of 39.8 ± 1.6 weeks were investigated during the first 6 hours of life. Measurements were obtained in both supine and prone positions using a computerized volume‐flow system. There were statistically significant decreases in crying vital capacity (CVC) and peak expiratory flow rate (PEF) in the prone compared with the supine position. However, there were no significant differences in forced expiratory flow rate at 75% (V75), 50% (V50), and 25% (V25) of vital capacity between the two positions. These results suggest that prone positioning decreases lung volume and increases resistance of upper airways. We conclude that healthy neonates should be in the supine posture for optimal ventilation. Pediatr Pulmonol. 1996; 21:167–170. © 1996 Wiley‐Liss, Inc.

Position and ventilatory response to added dead space in prematurely born infants

“…An alternative explanation is that the infant's ability to respond to the stimulus was impaired in the prone position, consistent with our finding of lower MIOP in the prone compared to the supine position. It is possible that head position might affect the MIOP results, as head turning can result in deformation of the airways, 10 but we have previously demonstrated the supine posture, regardless of head position, was associated with a significantly higher respiratory muscle strength than the prone posture 7 and in this study took particular care to control the neck position and avoid flexion. A lower MIOP may not reflect lower respiratory muscle strength if there is chest wall distortion, as under such conditions increased diaphragmatic activity may not transmit an increased occlusion pressure.…”

Effect of posture on oxygenation and respiratory muscle strength in convalescent infants

“…In addition, head turning results in deformation of the airways. 19 A second study was therefore performed in which each infant was assessed in both the supine and prone posture with the head to the right, as well as in the supine posture with the head to the midline. The supine posture, regardless of head position, was associated with a significantly higher PIMAX than the prone posture.…”

The effect of positioning on the stability of oxygenation and respiratory synchrony in non‐ventilated pre‐term infants

“…The importance of risk factors cannot be ignored within specific populations of infants but reports suggest that some 80% of SIDS babies are born full term and of normal birth weight ( Department of Health 1993). Advice to this group of infants is supported by the results of a recent study of healthy neonates by Shen et al . (1996 ), which suggests that the supine position is optimum for ventilation in the healthy term infant.…”