Prone versus supine position in artificially ventilated neonates

Abstract EN

Changes in body position can significantly improve gas exchange with few complications related to the maneuver.

This may result in a shorter stay in the critical care unit and improved, outcome for the critically ill patient.

Aims : to study the effects of prone' versus supine position in infants with respiratory failure by using two modes, of ventilation.

Methods: This study was carried out on 60 neonates (39 females, 21 males).

Artificially ventilated admitted to the neonatal intensive care unit, Tanta University Hospital.

All neonates were suffering from respiratory failure and requiring intubation and mechanical ventilation.

Patients were classified into four groups.

Group la includes 15 neonates who were ventilated by PCV mode in the prone position.

Group lb includes 15 neonates who were ventilated by PCV mode in the supine position.

Group 1 ia includes 15 neonates who were ventilated by SIMV mode in the prone position.

Group lib includes 15 neonates who were ventilated by SIMV mode in the supine position.

In group la & lla, parameters were measured during supine position before turning infants to the prone position (baseline) and then they were turned prone and parameters were measured after hour.

Infants remained in the prone position for 20 hours and parameters were measured again and after those infants returned to the supine position and parameters were measured after 1 hour.

In group lb & Mb, parameters were measured at baseline after 1 hour, 20 hours and 21 hours.

Results : the results of our study showed that there was a significant increase in tidal volume in group lla when compared to group lib at 1 hour and 20 hours after turning infants to the prone position but there was no significant difference after returning to the supine position.

Also there was a significant decrease in mean airway pressure in group la and lla when compared to group lb and lib respectively after 20 hours of the prone position and also after returning to the supine position.

The results of our study also showed a significant improvement in Pa02 / Fi02 ratio and Sp02 after turning infants to the prone position and also after returning to the supine position when compared to the base line data.

When comparing short duration of prone position to long duration there were also a significant improvement in PaO^FiC^and Sp02 with longer duration of the prone position.

When comparing short duration of prone position to long duration there were also a significant decrease in oxygenation index with longer duration of the prone position.

When comparing group la and lla to lb and lib respectively, the oxygenation index was significantly lower in group la and lla.

When comparing group la to lla, the oxygenation index was significantly lower in group lla.

But there were no significant changes in PH, PaC02, HC03, minute volume, heart rate and.

mean arterial blood pressure either within the same group or when comparing the groups with each other.