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Effect of body position on ventilation distribution in healthy newborn infants: an observational study
  1. Marika Rahtu1,
  2. Inéz Frerichs2,
  3. Tytti Pokka1,3,
  4. Tobias Becher2,
  5. Outi Peltoniemi1,
  6. Merja Kallio1
  1. 1 Department of Pediatrics and Adolescent Medicine and Research Unit of Clinical Medicine, Oulu University Hospital, Oulu, Finland
  2. 2 Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Schleswig-Holstein, Germany
  3. 3 Research Service Unit, Oulu University Hospital, Oulu, Finland
  1. Correspondence to Marika Rahtu, Department of Pediatrics and Adolescent Medicine and Research Unit of Clinical Medicine, Oulu University Hospital, Oulu, Finland; marika.rahtu{at}


Objectives Newborn infants have unique respiratory physiology compared with older children and adults due to their lungs’ structural and functional immaturity and highly compliant chest wall. To date, ventilation distribution has seldom been studied in this age group. This study aims to assess the effect of body position on ventilation distribution in spontaneously breathing healthy neonates.

Design Prospective observational study.

Setting Maternity wards of Oulu University Hospital.

Patients 20 healthy, spontaneously breathing, newborn infants.

Interventions Electrical impedance tomography data were recorded with a 32-electrode belt (Sentec AG, Landquart, Switzerland) in six different body positions in random order. Ventilation distribution was retrospectively assessed 10 minutes after each position change.

Main outcome measures In each position, regional tidal impedance variation (ΔZ) and ventral-to-dorsal and right-to-left centre of ventilation were measured.

Results The mean global ΔZ was the largest in supine position and it was smaller in prone and lateral positions. Yet, global ΔZ did not differ in supine positions, ventilation distribution was more directed towards the non-dependent lung region in supine tilted position (p<0.001). In prone, a reduction of global ΔZ was observed (p<0.05) corresponding to an amount of 10% of global tidal variation in supine position. In both lateral positions, tidal ventilation was distributed more to the corresponding non-dependent lung region.

Conclusions Prone or lateral body positioning in healthy spontaneously breathing newborns leads to a redistribution of ventilation to the non-dependent lung regions and at the same time global tidal volume is reduced as compared with supine.

  • Neonatology
  • Paediatrics
  • Intensive Care Units, Neonatal

Data availability statement

No data are available. Not applicable.

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Data availability statement

No data are available. Not applicable.

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  • Contributors Conception and study design: MK, IF and MR. Data acquisition: MR. Analysis and interpretation of the data: MR, TP, IF, TB, OP and MK. Drafting of the manuscript: MR, IF, TP, TB, OP and MK. Quarantor for the work: MK. All authors have read and approved the manuscript.

  • Funding MR received a personal research grant from the Alma and K.A. Snellman Foundation, Oulu, Finland and the Finnish Cultural Foundation. MK was supported by the Finnish Foundation for Pediatric Research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.