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Nazal ve sürekli hava yolu basıncı (N-CPAP) altında sırtüstü ve yüzükoyun pozisyonların preterm bebeklerin fizyolojik parametreleri üzerindeki etkisinin karşılaştırılması: bir çapraz klinik çalışma

Year 2019, Volume: 44 Issue: 4, 1250 - 1255, 29.12.2019
https://doi.org/10.17826/cumj.512192

Abstract

Amaç: Bu çalışmanın amacı, sırtüstü ve yüzüstü konumların nazal sürekli pozitif hava yolu basıncı (N-CPAP) altındaki preterm bebeklerin fizyolojik parametreleri üzerindeki etkilerini karşılaştırmaktır.

Gereç ve Yöntem: Bu çapraz klinik çalışma, İran' Kermanşah'taki İmam Reza Hastanesi Yenidoğan yoğun bakım ünitesinde N-CPAP altındaki 62 hastaneye yatmış erken doğmuş bebek üzerinde yapıldı. Yenidoğanlar ilk önce 180 dakika boyunca sırtüstü pozisyona getirildi ve daha sonra onların pozisyonu 180 dakika yüzüstü bir pozisyona getirildi. Bu süre zarfında kalp atım hızı (HR), solunum hızı (RR) ve arteriyel oksijen satürasyonu (So2) her 15 dakikada bir iki pozisyonda değerlendirildi.

Bulgular: İki pozisyonda İK araçlarında anlamlı fark gözlendi. Yüzüstü pozisyonda RR, sırtüstü pozisyondan anlamlı derecede düşüktü; ancak, yüzüstü pozisyonda So2 sırtüstü pozisyondan anlamlı derecede yüksekti.

Sonuç: Bu çalışmanın sonuçları, N-CPAP altında solunum sıkıntısı sendromu olan erken doğmuş bebeklerde, sırtüstü pozisyona kıyasla yüzüstü pozisyonda daha düşük RR ve daha yüksek So2 olduğunu göstermiştir. Bu nedenle, erken doğmuş bebekler yüzüstü pozisyonda daha iyi fizyolojik stabiliteye sahiptir.


References

  • 1. Martin RJ, Fanaroff AA, Walsh MC. Perinatal and Neonatal care in developing countries. fanaroff and martin's neonatal-perinatal medicine: diseases of the fetus and infant. 10th ed. Philadelphia: Mosby Elsevier; 2015.2. Yu VY. Global, regional and national perinatal and neonatal mortality. Journal of perinatal medicine. 2003 Oct 1; 31(5):376-9.3. Ghorbani F, Valizadeh S, Asadollahi M. Comparison of Prone and Supine Positions on Oxygenation of Premature Infants with Respiratory Distress Syndrome Treated with Nasal CPAP in Tabriz Alzahra Hospital, 2010, Tabriz, Iran. Qom Univ Med Sci J. 2012; 6(4): 57-63. [Text in Persian ]4. Eghbalian F, Moeinipour A. Effect of neonatal position on oxygen saturation in Hospitalized premature infants with respiratory distress syndrome. Annali Military Health Sci Res 2008; 6(1): 9-13. [Text in Persian] 5. Courtney SE, Pyon KH, Saslow JG, Arnold GK, Pandit PB, Habib RH. Lung recruitment and breathing pattern during variable versus continuous flow nasal continuous positive airway pressure in prenmature infants: An evaluation of 3 devices. Pediatrics 2001; 107(2:):304-8.6. Gergegory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. treatment of the idiopathic respiratory distress syndrome with continuous positive airway pressure. N Engl J Med 1971; 284:1333-40.7. Curley MA, Arnold JH, Thompson JE, Fackler JC, Grant MJ, Fineman LD, et al. Clinical trial design-effect of prone positioning on clinical outcomes in infants and children with acute respiratory distress syndrome. J Crit Care. 2006;21(1):23-32.8. Alinejad-Naine M. Neonatal positioning during care in neonatal intensive care unit. Iranian Journal of Cardiovascular Nursing. 2014 Jun 15;3(1):60-5.9. Balaguer A, Escribano J,Roque M. Infant in neonate receiving mechanical ventilation. Cochrane Database Syst Rev. 2006 Oct 18 ;(4):CD003668.10. Brayan AC. Comments of a devil's advocate .Am Rev .respir Dis. 1974; 110: 143-144. 11. Wells DA, Gillies D, Fitz Gerald DA. Positioning for acute respiratory distress in hospitalised infants and children. Cochrane Database Rev.2005; 18 (2): 255-259.12. Chang YJ, Anderson GC, Dowling D: Decreased activity and oxygen desaturation in prone ventilated preterm infants during the first postnatal week. Hear Lung. 2002; 31 (1) : 34-42.13. Bhat Ry, Leipala JA, Singh NR. Effect of posture on oxygenation, lung Volume and respiratory mechanics in premature infants studied before discharge. Pediatrics. 2003; 112 (1): 29-32.14. Casado FJ, Martinez DA, Ruiz-Lopez MJ, et al. Pediatric ARDS: effect of supine-prone postural changes on oxygenation. Intensive Care Med. 2002; 28 (12): 1792- 1796.15. Gardner SL, Goldson E. Intervention positioning: The neonate and the environmet. In: Merestein GB, Gardner SL. Handbook of Neonatal intensive care, 5th ed. Mosby Inc. 2002:659-660. 16. Corvaglia L, Rotatori R, Ferlini M, et al. The effect of body positioning on gastroesophageal reflux in premature infants: Evaluation by combined impedance and PH monitoring. j peds. 2007. 06: 591-596.17. Yao WX. Xue XD. Fu JH. Effect of position on oxygenation in neonates after weaning from mechanical ventilation. Zhongguo Dang Dai Er Ke Za Zhi. 2008 Apr; 10(2):121-4. . [Text in Chinese].18. Abdeyazdan Z, Nematollahi M, Ghazavi Z, Mohhamadizadeh M. The effects of supine and prone positions on oxygenation in premature infants undergoing mechanical ventilation. Iranian J Nurs Midwifery Res 2010; 15(4): 229- 33.19. Gouna G, Rakza T, Kuissi E, Pennaforte T, Mur S, Storme L. Positioning effects on lung function and breathing pattern in premature newborns. The Journal of pediatrics. 2013 Jun 30; 162(6):1133-7.20. Elder ED, Campbell gA, Doherty AD. Prone or supine for infants with chronic lung disease at neonatal discharge. Pediatr J.2005; 41: 180-185.21. Torabi Z, Ghaheri V, Falak Aflaki B. The Effect of Body Position on the Arterial Oxygen Saturation of Healthy Premature Neonates: A Clinical Trial. J Mazand Univ Med Sci. 2012; 22(86): 234-242. Persian.22. Baird TM, Paton JB, Fisher DE. Improved oxygenation with prone positioning in neonates: Stability of increase transcutaneous poz .j perinatal. 1991; 11 (4) :315-318.23. Vafaienejad T, Fakhr-Movahedi A, Salimi T, Nooripur S. COMPARING THE EFFECT OF PRONE AND SUPINE POSITIONS ON RESPIRATORY STATUS OF ACUTE RESPIRATORY DISTRESS SYNDROME NEWBORNS TREATED BY INSURE PROTOCOL. Journal of Urmia Nursing And Midwifery Faculty. 2015 May 15; 13(2):116-23.24. Balali F, Jafari Z, Dabirian A, Heidarzadeh M, Nasiri M. The effect of posture in premature infants on the arterial oxygen saturation, fraction of inspired oxygen and abdominal distension. Feyz Journal of Kashan University of Medical Sciences. 2017; 21(5):470-6.25. Farhat A, Mohammad zadeh A, Ali zadeh E, Amiri M. Effect of Care Position on Oxygen Saturation in Healthy Low Birth Weight Infants. Med J Mashad Univ Med Sci 2005; 48(87): 85-8.[in Persian]26. Ghorbani F, Asadollahi M, Valizadeh S, Comparison the effect of Sleep Positioning on Cardiorespiratory Rate in Noninvasive Ventilated Premature Infants. J Kashan kowsar 2013; 1(4):182-7.27. Trícia G, OliveiraI; Maria A. S, RegoII; Nadja C, PereiraIII; Lorena O, VazIV; Danielle C, FrançaI; Danielle S. R, et al. Prone position and reduced thoracoabdominal asynchrony in preterm newborns .J. Pediatr 2009; 85 (5):443-8. 28. Heimler R, Langlois J, Hodel DJ, Nelin LD, Sasidharan P. Effect of positioning on the breathing pattern of preterm infants. Archives of disease in childhood. 1992 Mar 1; 67(3):312-4.29. Ma M, Noori S, Maarek JM, Holschneider DP, Rubinstein EH, Seri I. Prone positioning decreases cardiac output and increases systemic vascular resistance in neonates. Journal of Perinatology. 2015 Jun 1; 35(6):424-7.

Comparison of the effect of supine and prone positions on physiological parameters of preterm infants under nasal continuous positive airway pressure (N-CPAP): a cross over clinical trial

Year 2019, Volume: 44 Issue: 4, 1250 - 1255, 29.12.2019
https://doi.org/10.17826/cumj.512192

Abstract

Purpose: The aim of this study was to compare the effect of supine and prone positions on physiological parameters of preterm infants under nasal continuous positive airway pressure (N-CPAP). 

Materials and Methods: This cross-over clinical trial was conducted on 62 hospitalized preterm infants under N-CPAP in the neonatal intensive care unit of Imam Reza Hospital Kermanshah, Iran. Neonates were placed in supine position at first for 180 minutes and then their position was changed into prone position for another 180 minutes. During this period, heart rate (HR), respiratory rate (RR) and arterial oxygen saturation (So2) were assessed once every 15 minutes in two positions. 

Results: There was significant difference observed in the means of HR in two positions. The RR in the prone position was significantly lower than that in the supine position; however, the So2 in the prone position was significantly higher than the supine position.

Conclusion: The results of this study showed in preterm infants with respiratory distress syndrome under N-CPAP, there was lower RR and higher So2 in prone position when compared to the supine position. Therefore, preterm infants have better physiological stability in prone position.



References

  • 1. Martin RJ, Fanaroff AA, Walsh MC. Perinatal and Neonatal care in developing countries. fanaroff and martin's neonatal-perinatal medicine: diseases of the fetus and infant. 10th ed. Philadelphia: Mosby Elsevier; 2015.2. Yu VY. Global, regional and national perinatal and neonatal mortality. Journal of perinatal medicine. 2003 Oct 1; 31(5):376-9.3. Ghorbani F, Valizadeh S, Asadollahi M. Comparison of Prone and Supine Positions on Oxygenation of Premature Infants with Respiratory Distress Syndrome Treated with Nasal CPAP in Tabriz Alzahra Hospital, 2010, Tabriz, Iran. Qom Univ Med Sci J. 2012; 6(4): 57-63. [Text in Persian ]4. Eghbalian F, Moeinipour A. Effect of neonatal position on oxygen saturation in Hospitalized premature infants with respiratory distress syndrome. Annali Military Health Sci Res 2008; 6(1): 9-13. [Text in Persian] 5. Courtney SE, Pyon KH, Saslow JG, Arnold GK, Pandit PB, Habib RH. Lung recruitment and breathing pattern during variable versus continuous flow nasal continuous positive airway pressure in prenmature infants: An evaluation of 3 devices. Pediatrics 2001; 107(2:):304-8.6. Gergegory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. treatment of the idiopathic respiratory distress syndrome with continuous positive airway pressure. N Engl J Med 1971; 284:1333-40.7. Curley MA, Arnold JH, Thompson JE, Fackler JC, Grant MJ, Fineman LD, et al. Clinical trial design-effect of prone positioning on clinical outcomes in infants and children with acute respiratory distress syndrome. J Crit Care. 2006;21(1):23-32.8. Alinejad-Naine M. Neonatal positioning during care in neonatal intensive care unit. Iranian Journal of Cardiovascular Nursing. 2014 Jun 15;3(1):60-5.9. Balaguer A, Escribano J,Roque M. Infant in neonate receiving mechanical ventilation. Cochrane Database Syst Rev. 2006 Oct 18 ;(4):CD003668.10. Brayan AC. Comments of a devil's advocate .Am Rev .respir Dis. 1974; 110: 143-144. 11. Wells DA, Gillies D, Fitz Gerald DA. Positioning for acute respiratory distress in hospitalised infants and children. Cochrane Database Rev.2005; 18 (2): 255-259.12. Chang YJ, Anderson GC, Dowling D: Decreased activity and oxygen desaturation in prone ventilated preterm infants during the first postnatal week. Hear Lung. 2002; 31 (1) : 34-42.13. Bhat Ry, Leipala JA, Singh NR. Effect of posture on oxygenation, lung Volume and respiratory mechanics in premature infants studied before discharge. Pediatrics. 2003; 112 (1): 29-32.14. Casado FJ, Martinez DA, Ruiz-Lopez MJ, et al. Pediatric ARDS: effect of supine-prone postural changes on oxygenation. Intensive Care Med. 2002; 28 (12): 1792- 1796.15. Gardner SL, Goldson E. Intervention positioning: The neonate and the environmet. In: Merestein GB, Gardner SL. Handbook of Neonatal intensive care, 5th ed. Mosby Inc. 2002:659-660. 16. Corvaglia L, Rotatori R, Ferlini M, et al. The effect of body positioning on gastroesophageal reflux in premature infants: Evaluation by combined impedance and PH monitoring. j peds. 2007. 06: 591-596.17. Yao WX. Xue XD. Fu JH. Effect of position on oxygenation in neonates after weaning from mechanical ventilation. Zhongguo Dang Dai Er Ke Za Zhi. 2008 Apr; 10(2):121-4. . [Text in Chinese].18. Abdeyazdan Z, Nematollahi M, Ghazavi Z, Mohhamadizadeh M. The effects of supine and prone positions on oxygenation in premature infants undergoing mechanical ventilation. Iranian J Nurs Midwifery Res 2010; 15(4): 229- 33.19. Gouna G, Rakza T, Kuissi E, Pennaforte T, Mur S, Storme L. Positioning effects on lung function and breathing pattern in premature newborns. The Journal of pediatrics. 2013 Jun 30; 162(6):1133-7.20. Elder ED, Campbell gA, Doherty AD. Prone or supine for infants with chronic lung disease at neonatal discharge. Pediatr J.2005; 41: 180-185.21. Torabi Z, Ghaheri V, Falak Aflaki B. The Effect of Body Position on the Arterial Oxygen Saturation of Healthy Premature Neonates: A Clinical Trial. J Mazand Univ Med Sci. 2012; 22(86): 234-242. Persian.22. Baird TM, Paton JB, Fisher DE. Improved oxygenation with prone positioning in neonates: Stability of increase transcutaneous poz .j perinatal. 1991; 11 (4) :315-318.23. Vafaienejad T, Fakhr-Movahedi A, Salimi T, Nooripur S. COMPARING THE EFFECT OF PRONE AND SUPINE POSITIONS ON RESPIRATORY STATUS OF ACUTE RESPIRATORY DISTRESS SYNDROME NEWBORNS TREATED BY INSURE PROTOCOL. Journal of Urmia Nursing And Midwifery Faculty. 2015 May 15; 13(2):116-23.24. Balali F, Jafari Z, Dabirian A, Heidarzadeh M, Nasiri M. The effect of posture in premature infants on the arterial oxygen saturation, fraction of inspired oxygen and abdominal distension. Feyz Journal of Kashan University of Medical Sciences. 2017; 21(5):470-6.25. Farhat A, Mohammad zadeh A, Ali zadeh E, Amiri M. Effect of Care Position on Oxygen Saturation in Healthy Low Birth Weight Infants. Med J Mashad Univ Med Sci 2005; 48(87): 85-8.[in Persian]26. Ghorbani F, Asadollahi M, Valizadeh S, Comparison the effect of Sleep Positioning on Cardiorespiratory Rate in Noninvasive Ventilated Premature Infants. J Kashan kowsar 2013; 1(4):182-7.27. Trícia G, OliveiraI; Maria A. S, RegoII; Nadja C, PereiraIII; Lorena O, VazIV; Danielle C, FrançaI; Danielle S. R, et al. Prone position and reduced thoracoabdominal asynchrony in preterm newborns .J. Pediatr 2009; 85 (5):443-8. 28. Heimler R, Langlois J, Hodel DJ, Nelin LD, Sasidharan P. Effect of positioning on the breathing pattern of preterm infants. Archives of disease in childhood. 1992 Mar 1; 67(3):312-4.29. Ma M, Noori S, Maarek JM, Holschneider DP, Rubinstein EH, Seri I. Prone positioning decreases cardiac output and increases systemic vascular resistance in neonates. Journal of Perinatology. 2015 Jun 1; 35(6):424-7.
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Details

Primary Language English
Subjects Paediatrics, Clinical Sciences
Journal Section Research
Authors

Homa Babaei This is me 0000-0003-0703-8178

Leila Mohammadi Pirkashani 0000-0002-1138-9942

Behzad Soleimani This is me 0000-0002-9352-0376

Publication Date December 29, 2019
Acceptance Date March 24, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Babaei, Homa et al. “Comparison of the Effect of Supine and Prone Positions on Physiological Parameters of Preterm Infants under Nasal Continuous Positive Airway Pressure (N-CPAP): A Cross over Clinical Trial”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1250-5, doi:10.17826/cumj.512192.