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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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.