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The Role of Prone Position Combined With Nasal CPAP in Preventing Extubation Failure in Infants After Cardiac Surgery

Hong-Lin Wu1, Yu-Kun Chen1, Shi-Hao Lin1

  • 1Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

Respiratory Care
|January 31, 2025
PubMed

Insights

Prone positioning in infants after cardiac surgery significantly reduced extubation failure and improved oxygenation. This intervention also shortened nasal CPAP duration and hospital stays.

Area of Science:

  • Pediatric Cardiac Surgery
  • Respiratory Support
  • Critical Care Medicine

Background:

  • Prone positioning may enhance oxygenation and prevent lung injury.
  • Its effect on post-extubation outcomes in infants after cardiac surgery remains unclear.

Purpose of the Study:

  • To investigate the impact of prone positioning on preventing extubation failure in infants receiving noninvasive ventilation post-cardiac surgery.

Main Methods:

  • 96 infants undergoing cardiac surgery were randomized into prone (n=48) or supine (n=48) groups after nasal CPAP weaning.
  • Primary outcomes: extubation failure rate (48h) and arterial blood gas values (6h).
  • Secondary outcomes: nasal trauma, pressure ulcers, pneumothorax, reflux, abdominal distention, mortality, CPAP duration, and hospital stay.

Main Results:

  • The prone group showed significantly lower extubation failure rates (2.0% vs 14.5%, P=.02).
  • Prone positioning improved oxygenation (PaO2, PaO2/FiO2) and reduced nasal CPAP duration and hospital length of stay (P<.05).

Conclusions:

  • Prone positioning enhances postextubation oxygenation in infants post-cardiac surgery.
  • It effectively reduces extubation failure, shortens nasal CPAP duration, and decreases overall hospital length of stay.
Abstract

Keywords:
cardiac surgeryinfantsnoninvasive ventilationprone positioning

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