Respiratory Function in Ventilated Newborn Infants Nursed Prone and Supine.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-04-01 DOI:10.1002/ppul.71075

Konstantina Barka, Eleni Papachatzi, Sotirios Fouzas, Gabriel Dimitriou, Theodore Dassios

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引用次数: 0

Abstract

Objectives: Prone positioning has been associated with improved oxygenation in ventilated newborn infants but the physiological basis of this improvement has not been previously studied. We aimed to test the hypothesis that respiratory function measured by composite physiological indices would be improved in the prone compared to the supine position.

Study design: Prospective observational study of ventilated newborns in a tertiary neonatal unit studied prone and supine at random order.

Methodology: The ventilation to perfusion ratio (V_A/Q) and right to left shunt were non-invasively calculated using the oxyhemoglobin dissociation curve method. The gradient of the arterial to end tidal carbon dioxide (PaCO₂ - EtCO₂ gradient) was calculated to describe changes in the alveolar dead space.

Results: Forty-six (26 male) infants with a median (IQR) gestational age of 34.8 (33.1-36.3) weeks and birth weight of 2.34 (1.77-2.87) kg were studied after 5 (2-10) hours of invasive ventilation. The V_A/Q was significantly higher in the prone position [0.57 (0.52-0.63)] compared to supine [0.53 (0.46-0.62), p = 0.001]. Right to left shunt was significantly lower in prone [7 (0-12) %] compared to supine [9 (1-16) %, p = 0.003]. The PaCO₂ - EtCO₂ gradient was significantly lower in prone [6.3 (3.8-8.4) mmHg] compared to supine [12.1 (7.1-16.0) mmHg].

Conclusions: The prone position in ventilated neonates was associated with improved ventilation to perfusion matching and lower intrapulmonary shunting and alveolar dead space compared to supine.

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俯卧和仰卧护理下通气新生儿的呼吸功能。

目的：俯卧位与通气新生儿氧合改善有关，但这种改善的生理基础此前尚未研究。我们的目的是验证由综合生理指标测量的呼吸功能在俯卧位比仰卧位会得到改善的假设。研究设计：前瞻性观察研究在三级新生儿病房通气新生儿研究俯卧和仰卧随机顺序。方法：采用氧解离曲线法无创计算通气灌注比（VA/Q）和右至左分流。计算动脉血末二氧化碳梯度（PaCO2 - EtCO2梯度）来描述肺泡死腔的变化。结果：有创通气5（2-10）小时后，研究了46例（26例）男婴，中位胎龄34.8（33.1-36.3）周，出生体重2.34 (1.77-2.87)kg。俯卧位VA/Q[0.57(0.52-0.63)]明显高于仰卧位[0.53 (0.46-0.62),p = 0.001]。俯卧位右至左分流率[7(0-12)%]明显低于仰卧位[9 (1-16)%,p = 0.003]。俯卧位PaCO2 - EtCO2梯度[6.3 (3.8-8.4)mmHg]明显低于仰卧位PaCO2 - EtCO2梯度[12.1 (7.1-16.0)mmHg]。结论：与仰卧位相比，新生儿俯卧位通气与灌注匹配改善，肺内分流和肺泡死腔减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.