OBJECTIVE: To compare the effects of supine and prone positions on oxygen saturation (SpO(2)), desaturation episodes (SpO(2) < 90% and >or= 20 seconds), and motor activity in ventilated preterm infants during their first postnatal week. DESIGN: With use of a crossover design, we randomly assigned infants to a supine/prone or prone/supine position sequence. Infants were placed in each position for 2 hours. A stabilization period of 10 minutes before observation of each position was allowed. During the protocol, care procedures were kept minimal and ventilator settings remained unchanged. SETTING:Neonatal intensive care units at 2 tertiary care centers in Taiwan. SAMPLE: The sample consisted of 28 infants receivingmechanical ventilation who were 25 to 36 weeks' gestation, without known congenital abnormalities, within 7 postnatal days of birth, and were not receiving sedation. RESULTS: When prone, infants had higher SpO(2), fewer episodes of oxygen desaturation, and less motor activity than when supine. No significant differences in duration of SpO(2) less than 90%, 85%, and 80% were found between the 2 positions. Seventy-four percent of desaturation episodes were associated with vigorous motor activity and crying. CONCLUSION: The prone position results in less motor activity and may stabilize oxygenation for ventilated preterm infants. This may conserve energy and decrease complications of hypoxia for sick preterm infants.
RCT Entities:
OBJECTIVE: To compare the effects of supine and prone positions on oxygen saturation (SpO(2)), desaturation episodes (SpO(2) < 90% and >or= 20 seconds), and motor activity in ventilated preterm infants during their first postnatal week. DESIGN: With use of a crossover design, we randomly assigned infants to a supine/prone or prone/supine position sequence. Infants were placed in each position for 2 hours. A stabilization period of 10 minutes before observation of each position was allowed. During the protocol, care procedures were kept minimal and ventilator settings remained unchanged. SETTING: Neonatal intensive care units at 2 tertiary care centers in Taiwan. SAMPLE: The sample consisted of 28 infants receiving mechanical ventilation who were 25 to 36 weeks' gestation, without known congenital abnormalities, within 7 postnatal days of birth, and were not receiving sedation. RESULTS: When prone, infants had higher SpO(2), fewer episodes of oxygen desaturation, and less motor activity than when supine. No significant differences in duration of SpO(2) less than 90%, 85%, and 80% were found between the 2 positions. Seventy-four percent of desaturation episodes were associated with vigorous motor activity and crying. CONCLUSION: The prone position results in less motor activity and may stabilize oxygenation for ventilated preterm infants. This may conserve energy and decrease complications of hypoxia for sick preterm infants.
Authors: May Rivas-Fernandez; Marta Roqué I Figuls; Ana Diez-Izquierdo; Joaquin Escribano; Albert Balaguer Journal: Cochrane Database Syst Rev Date: 2016-11-07