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Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure

Judith L Hough1, Leanne Johnston, Sandy G Brauer

  • 1Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Health Services, South Brisbane, QLD, Australia. judith. hough@mater.org.au

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|September 20, 2011
PubMed

Insights

Body position had minimal impact on lung ventilation in preterm infants receiving continuous positive airway pressure (CPAP). Ventilation distribution in these infants followed an anatomical pattern rather than being gravity-dependent.

Area of Science:

  • Neonatal Physiology
  • Respiratory Medicine
  • Medical Imaging

Background:

  • Continuous positive airway pressure (CPAP) is widely used in neonatal intensive care units.
  • Positioning is believed to be crucial for maintaining lung ventilation.
  • No prior data existed on regional ventilation distribution in infants on CPAP.

Purpose of the Study:

  • To investigate the effect of body position on regional ventilation distribution.
  • Utilized electrical impedance tomography (EIT) in preterm infants on CPAP.

Main Methods:

  • Randomized crossover study design in a neonatal intensive care unit.
  • Compared 24 preterm infants on CPAP with 6 spontaneously breathing preterm infants.
  • Assessed regional ventilation in supine, prone, and quarter prone positions.

Main Results:

  • No significant differences in ventilation distribution were observed between body positions.
  • Regional tidal volume was higher in posterior vs. anterior and right vs. left lungs.
  • Ventilation inhomogeneity was greater in infants on CPAP compared to healthy infants.

Conclusions:

  • This study provides the first EIT data on regional ventilation in preterm infants on CPAP.
  • Gravity showed minimal impact on ventilation distribution, suggesting an anatomical pattern.
  • Ventilation distribution in preterm infants on CPAP is not gravity-dependent.
Abstract

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