Effect of prone positioning on respiratory function in very preterm infants undergoing mechanical ventilation

Abstract:

Objective To explore the effect of prone positioning on respiratory function in very preterm infants undergoing mechanical ventilation.Methods A total of 83 very preterm infants treated with mechanical ventilation were enrolled in the study and were randomly assigned to supine group and prone group. Four infants withdrew from the study and 79 infants completed treatment and observation (37 in the supine group and 42 in the prone group). Infants in both groups were mechanically ventilated in a volume assist-control mode. Infants in the prone group were ventilated in the supine position for 4 hours and in the prone position for 2 hours. Ventilator parameters, arterial blood gas analysis, and vital signs were recorded before grouping, every 6 hours in the supine group, and every hour after conversion into the prone position in the prone group, respectively.Results Fraction of inspired oxygen (FiO₂), peak inspiratory pressure, mean inspiratory pressure, and duration of ventilation were significantly lower in the prone group than in the supine group (P < 0.05); there were no significant differences in tidal volume or positive end-expiratory pressure between the two groups (P > 0.05). The prone group had a significantly higher PO₂/FiO₂ ratio but significantly lower oxygenation index and respiratory rate than the supine group (P < 0.05). There were no significant differences in arterial oxygen tension, pH, base excess, heart rate, or mean blood pressure between the two groups (P > 0.05).Conclusions Alternating ventilation between the prone position and supine position can improve oxygenation function, decrease the fraction of inspired oxygen, and shorten the duration of mechanical ventilation in very preterm infants undergoing mechanical ventilation.