Abstract

Background: Apnoea of prematurity has been shown to respond to changes in posture.

Objective: To investigate the effect of three postural interventions on the rate of bradycardia and desaturation events.

Methods: 18 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 of three different prone positions. The following interventions were applied in random order: horizontal position (HP), 15° head-up tilt position (TP) and three-level position (3P) according to Kinaesthetics Infant Handling. The primary study variable was the combined event rate of desaturations (SpO₂ <85%) and bradycardias (heart rate <80 bpm). One secondary study variable was the duration of body movements.

Results: The median (range) combined event rate was 26.7/h (0.3–72.7) in HP, 25.2/h (0.3–70.5) in TP and 21.2/h (0–66.3) in 3P (p>0.05). The median (range) duration of body movements was 10.8 s/h (0–48.2) in HP, 7.1 s/h (0–72.4) in TP and 7.0 s/h (0–47.7) in 3P (p>0.05).

Conclusions: No significant advantage of a head-up tilt or a three-level position over a standard horizontal position could be confirmed.