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

Maynard, Veronica; Bignall, S; Kitchen, Sheila

doi:10.1046/j.1365-2702.1999.0196c.x

Cited by 7 publications

(3 citation statements)

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“…Compared with supine, prone positioning in ventilated preterm infants has been shown to decrease the degree of thoracoabdominal asymmetry, which is an indirect measure of the work of breathing undertaken by the respiratory muscles 4 . Furthermore, prone positioning has been associated with decreased thoracoabdominal asynchrony in nonventilated premature infants 13,14 …”

Section: Discussionmentioning

confidence: 99%

Effect of prone and supine positioning on the diaphragmatic work of breathing in convalescent preterm infants

Dimitriou

Tsintoni

Vervenioti

et al. 2021

Pediatric Pulmonology

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Objectives To compare the work of breathing in the prone and supine positions in convalescent prematurely born infants. Working Hypothesis The work of breathing would be lower in the prone compared to the supine position. Study Design Prospective observational cohort study. Patient‐Subject Selection Consecutive preterm infants breathing unsupported in room air with a gestational age of 28–34 weeks in a tertiary neonatal intensive care unit were studied before discharge from neonatal care. Methodology The diaphragmatic pressure time product (PTPdi) was used to assess the work of breathing, calculated as the integration of transdiaphragmatic pressure over the inspiratory time. The PTPdi was measured in prone, supine, and supine with 45° head‐up tilt (supine‐tilt) positions. Results The mean (SD) PTPdi was lower in the prone (259 [68] cm H2O*s/min) compared with the supine position (320 [78] cm H2O*s/min, p= .005). The mean (SD) PTPdi was lower in the supine‐tilt position (262 [76] cm H2O*s/min) compared with the supine position (p = .032). The PTPdi was not different between the prone and supine‐tilt positions (p = .600). The difference in PTPdi between prone and supine was not independently associated with gestational age (standardized coefficient = 0.262, adjusted p= .335), birth weight (standardized coefficient = −0.249, adjusted p= .394) or postmenstrual age at study (standardized coefficient = −0.025, adjusted p= .902). Conclusions In convalescent preterm neonates, the work of breathing may be lower in the prone and supine‐tilt positions, compared with supine.

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Section: Discussionmentioning

confidence: 99%

Effect of prone and supine positioning on the diaphragmatic work of breathing in convalescent preterm infants

Dimitriou

Tsintoni

Vervenioti

et al. 2021

Pediatric Pulmonology

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“…A menor ocorrência de episódios de diminuição da SpO 2 em prono, no primeiro dia de desmame, pode ser devida à melhora da mecânica respiratória, pois em prono ocorre diminuição na assincronia toracoabddominal 8,15 .…”

Section: Discussionunclassified

“…Para o prematuro sadio ou mesmo doente, a posição prona apresenta vários benefícios na função respiratória, promovendo aumento da oxigenação, decréscimo do CO 2 expirado, melhora da complacência e da função diafragmá-tica e diminuição da assincronia toracoabdominal [6][7][8][9] .…”

Section: Introductionunclassified

Efeito da posição do prematuro no desmame da ventilação mecânica

Antunes¹,

Rugolo²,

Crocci³

2003

J. Pediatr. (Rio J.)

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Objective: the purpose of this study was to determine the effects of prone positioning on cardiorespiratory stability and weaning outcome of preterm infants during weaning from mechanical ventilation.Methods: from January to December 1999, a sample of 42 preterm infants, with birthweight < 2,000 g, mechanically ventilated in the first week of life, were randomly divided, in the beginning of the weaning process, in two groups according to the position: supine position (n = 21) or prone position (n = 21). Heart rate, respiratory rate, transcutaneous oxygen saturation and ventilatory parameters were recorded every one hour. Length of the weaning process and complications were also assessed.Results: in both groups the mean gestational age was 29 weeks, most of the patients presented very low birthweight and respiratory distress syndrome. The mean length of the weaning process was 2 days. There were no differences between the groups regarding respiratory rate, heart rate and transcutaneous oxygen saturation, however, oxygen desaturation episodes were more frequent in supine position (p = 0.009). Ventilatory parameters decreased faster and reintubation was less frequent in the prone group (4% versus 33%). No adverse effects of prone positioning were observed.Conclusion: these results suggest that prone position is a safe and beneficial procedure during the weaning from mechanical ventilation and may contribute to weaning success in preterm infants. ResumoObjetivo: o objetivo deste estudo foi determinar o efeito do posicionamento em prono na estabilidade cardiorrespiratória de prematuros, durante o desmame da ventilação mecânica e na evolução do desmame ventilatório.Método: de janeiro a dezembro de 1999, uma amostra de 42 prematuros, com peso de nascimento menor que 2.000g, em ventilação mecânica na primeira semana de vida, foram, no início do desmame, randomizados em dois grupos: supino (n=21), e prono (n=21). A freqüência cardíaca, freqüência respiratória, saturação de oxigênio e parâmetros ventilatórios foram avaliados a cada hora. A duração e as complicações do desmame também foram avaliadas.Resultados: em ambos os grupos, a média da idade gestacional foi de 29 semanas, a maioria dos pacientes foi de muito baixo peso ao nascimento, com síndrome do desconforto respiratório, e a mediana da duração do desmame foi de 2 dias. Não houve diferença entre os grupos na freqüência respiratória, na freqüência cardíaca e na saturação de oxigênio; entretanto, episódios de dessaturação foram mais freqüentes em supino (p=0,009). No grupo prono, os parâmetros ventilatórios foram diminuídos mais rapidamente, e a necessidade de reintubação foi menos freqüente (4% x 33%). Não houve efeitos adversos da posição prona.Conclusão: esses resultados sugerem que a posição prona é segura e benéfica durante o desmame da ventilação mecânica, e pode contribuir para o sucesso do desmame em prematuros. IntroduçãoHá grande questionamento na literatura quanto às posições supina e prona dos recém-nascidos (RN). Para o RN de termo sadio, a Am...

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Positioning for acute respiratory distress in hospitalised infants and children

Gillies¹,

Wells²

2005

Cochrane Database of Systematic Reviews

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

Cited by 7 publications

References 7 publications

Effect of prone and supine positioning on the diaphragmatic work of breathing in convalescent preterm infants

Effect of prone and supine positioning on the diaphragmatic work of breathing in convalescent preterm infants

Efeito da posição do prematuro no desmame da ventilação mecânica

Positioning for acute respiratory distress in hospitalised infants and children

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