ORIGINAL ARTICLE

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

G Dimitriou, A Greenough, L Pink, A McGhee, A Hickey, G F Rafferty

Children Nationwide Regional Neonatal Intensive Care Unit, King's College Hospital, London, UK

Correspondence to:
Correspondence to:
Professor Greenough, Department of Child Health, King's College Hospital, London SE5 9RS, UK;
anne.greenough{at}kcl.ac.uk

Objective: To determine if differences in respiratory muscle strength could explain any posture related effects on oxygenation in convalescent neonates.

Methods: Infants were examined in three postures: supine, supine with head up tilt of 45°, and prone. A subsequent study was performed to determine the influence of head position in the supine posture. In each posture/head position, oxygen saturation (SaO₂) was determined and respiratory muscle strength assessed by measurement of the maximum inspiratory pressure (PIMAX).

Patients: Twenty infants, median gestational age 34.5 weeks (range 25–43), and 10 infants, median gestational age 33 weeks (range 30–36), were entered into the first and second study respectively.

Results: Oxygenation was higher in the prone and supine with 45° head up tilt postures than in the supine posture (p<0.001), whereas PIMAX was higher in the supine and supine with head up tilt of 45° postures than in the prone posture (p<0.001). Head position did not influence the effect of posture on PIMAX or oxygenation.

Conclusion: Superior oxygenation in the prone posture in convalescent infants was not explained by greater respiratory muscle strength, as this was superior in the supine posture.

Keywords: posture; respiratory muscle strength; oxygenation

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