Apnoea of prematurity has been shown to respond to changes in posture. We investigated the effect of three postural interventions on the rate of bradycardia and desaturation events. Eighteen infants (<32 weeks gestational age; 11 boys) with apnoea of prematurity underwent recordings of breathing movements, electrocardiogram and instantaneous heart rate, pulse oximeter saturation (SpO2), photoplethysmographic waveforms, and digital video frame while in one out of 3 different prone positions.
The following interventions were applied in random order: horizontal position (HP), 15° head-up tilt position (TP), and 3-level position (3P) according to Kinaesthetics Infant Handling. Primary study variable was the combined event rate of desaturations (SpO2 < 85%) and bradycardias (heart rate < 80/minute). One secondary study variable was the duration of body movements. The median (range) combined event rate was 26.7/hour (0.3-72.7) in HP, 25.2/hour (0.3-70.5) in TP, and 21.2/hour (0-66.3) in 3P (p-value > 0.05). The median (range) duration of body movements was 10.8 seconds/hour (0-48.2) in HP, 7.1 seconds/hour (0-72.4) in TP and 7.0 seconds/hour (0-47.7) in 3P (p-value > 0.05).
We could not confirm a significant advantage of a head-up tilt or a 3-level position over a standard horizontal position.
- apnea of prematurity
- preterm infant
- prone position
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