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Prone versus supine positioning in the well preterm infant: effects on work of breathing and breathing patterns

Jennifer Levy1, Robert H Habib, Ellina Liptsen

  • 1Department of Pediatrics, Schneider Children's Hospital, North Shore Long Island Jewish Health System, New Hyde Park, New York 11040, USA.

Pediatric Pulmonology
|June 17, 2006
PubMed

Insights

Prone positioning does not reduce work of breathing in healthy premature infants nearing discharge. These findings suggest sleep position recommendations for healthy premature infants are similar to those for term infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Physiology

Background:

  • Premature infants with respiratory distress benefit from prone positioning for improved oxygenation and breathing synchrony.
  • The effect of prone positioning on the work of breathing (WOB) in healthy, convalescing premature infants is not well-established.

Purpose of the Study:

  • To investigate if prone positioning decreases the work of breathing in healthy premature infants nearing neonatal intensive care unit discharge.
  • To compare respiratory parameters between supine and prone positions in this population.

Main Methods:

  • Nineteen healthy premature infants were studied in both supine and prone positions.
  • Calibrated respiratory inductance plethysmography (RIP) measured tidal volume; esophageal catheter estimated pleural pressure.
  • Inspiratory, elastic, and resistive work of breathing were calculated.

Main Results:

  • Work of breathing (inspiratory, elastic, resistive) was not significantly affected by prone versus supine positioning (P = 0.46, 0.36, 0.87).
  • Respiratory rate, tidal volume, minute ventilation, and lung compliance showed no significant differences between positions.

Conclusions:

  • Prone positioning does not decrease the work of breathing in healthy premature infants who are no longer receiving oxygen support.
  • Sleep position recommendations for healthy, near-term-discharge premature infants should align with those for full-term infants.

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