Prone positioning decreases episodes of hypoxemia in extremely low birth weight infants (1000 grams or less) with chronic lung disease☆,☆☆,★
Section snippets
METHODS
Fifty-five neonates with CLD were prospectively studied during a 3-year period in the neonatal intensive care unit at Sacred Heart Hospital, Pensacola, Fla., and at Los Angeles County and University of Southern California Medical Center. The study was approved by the institutional review board at both institutions.
RESULTS
Prone positioning resulted in an overall increase in Sa o 2 from 92.0% ± 0.4% to 94.1% ± 0.4% (mean ± SEM; p <0.001). When an infant was prone, there was also a decrease in the percentage of time of desaturation to Sa o 2 of less than 90%, 85%, and 80% ( p <0.001), and a significant decrease in the percentage of time that the infants had Sa o 2 between 76% and 80%, 81% and 85%, and 86% and 90% ( p <0.001; Figure).
DISCUSSION
Neonates with acute lung disease are traditionally managed in the supine position to facilitate observation, easy access, and umbilical line management. However, as lung disease progresses, preterm infants manifest frequent episodes of hypoxemia. 1, 2 At this point, caretakers often choose the prone position as optimal for the infant from both an oxygenation and a comfort standpoint. Prior studies have demonstrated that prone positioning improves oxygenation in preterm infants with respiratory
Acknowledgements
We thank Dr. Richard J. Martin for critical review of the manuscript and the staff members of the newborn intensive care units for their support and cooperation.
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Oxygenation Instability Assessed by Oxygen Saturation Histograms during Supine vs Prone Position in Very Low Birthweight Infants Receiving Noninvasive Respiratory Support
2020, Journal of PediatricsCitation Excerpt :Using the SpO2 histograms we were able to quantify SpO2 instability and to document the time the infants spent in different SpO2 levels in each position. Different methods were used to assess the effect of body position on the oxygenation status of premature infants; among them were average SpO2 measurements, arterial oxygen saturation, transcutaneous PaO2, and manually recording desaturation events.7-13,16-18 These methods yielded inconclusive results regarding the superiority of prone position on oxygenation and did not evaluate the overall oxygenation instability in the different positions.14
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2015, Clinics in PerinatologyCitation Excerpt :Such asynchrony of chest wall motion is aggravated in the supine position. McEvoy and colleagues have56 documented that prone positioning decreases hypoxic episodes in infants with BPD, although this must be weighed against avoidance of that position before discharge. The contribution of pulmonary vasoconstriction to hypoxic spells in BPD has been recognized from the earliest descriptions of the disease.
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From the Division of Neonatology, Department of Pediatrics, Sacred Heart Hospital, University of Florida, Pensacola, and the Division of Neonatology, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center, Los Angeles.
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Reprint requests: Cindy McEvoy, MD Division of Neonatology, Sacred Heart Hospital, 5149 North Ninth Ave., Suite 302, Pensacola, FL 32504.
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0022-3476/97/$5.00 + 0 9/22/77679