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The prone position is associated with a decrease in respiratory system compliance in healthy anaesthetized infants.

R G Cox1, A Ewen, B B Bart

  • 1Alberta Children's Hospital, University of Calgary, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada. robin.cox@crha-health.ab.ca

Paediatric Anaesthesia
|May 22, 2001
PubMed
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In infants undergoing clubfoot surgery, prone positioning significantly reduced lung compliance (CDYN and CSTAT) compared to supine positioning. Gas exchange remained unaffected by the positional changes.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Respiratory Physiology

Background:

  • Infants undergoing surgery require careful anesthetic management.
  • Positional changes during surgery can affect pulmonary mechanics.
  • Understanding these effects is crucial for patient safety.

Purpose of the Study:

  • To evaluate the impact of supine versus prone positioning on pulmonary mechanics in anesthetized infants.
  • To assess changes in dynamic and static lung compliance.
  • To determine if gas exchange is clinically affected by repositioning.

Main Methods:

  • Ten healthy infants (ASA I or II) undergoing clubfoot surgery were studied.
  • General anesthesia was administered using rocuronium, nitrous oxide, and isoflurane.

Related Experiment Videos

  • Volume-controlled ventilation was delivered via a Mapleson-D system.
  • Pulmonary mechanics (CDYN, CSTAT) were measured in supine and prone positions using a Bicore CP-100 monitor.

    • Main Results:

    • Both dynamic compliance (CDYN) and static compliance (CSTAT) were significantly lower in the prone position (P < 0.0005).
    • Mean CDYN decreased from 14.9 ml.cmH2O-1 (supine) to 11.6 ml.cmH2O-1 (prone).
    • Mean CSTAT decreased from 10.2 ml.cmH2O-1 (supine) to 8.9 ml.cmH2O-1 (prone).
    • No clinically significant differences in gas exchange were observed between positions.

    Conclusions:

    • Prone positioning significantly decreases lung compliance in anesthetized infants.
    • Anesthesiologists should consider these changes in pulmonary mechanics when positioning infants.
    • Further research may explore strategies to mitigate these effects on lung compliance.