Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease

V. Vendettuoli, C. Veneroni, E. Zannin, D. Mercadante, P. Matassa, A. Pedotti, M. Colnaghi, R. L. Dellacà, F. Mosca

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background The role of prone position in preterm infants has not been completely clarified. We investigated prone versus supine posture-related changes in respiratory system resistance (Rrs) and reactance (Xrs) measured by the Forced Oscillation Technique (FOT) in mechanically ventilated preterm newborns. Methods Patients were studied in the supine versus prone positions in random order. Oxygen saturation, transcutaneous partial pressure of oxygen (ptcO2), carbon dioxide (ptcCO2), Rrs and Xrs were measured in each position. Results Nine patients with respiratory distress syndrome (RDS) and nine with evolving broncho-pulmonary dysplasia (BPD) were studied. Rrs was, on average, 9.8 (1.3, 18.3 as 95%CI) cmH2Os/l lower in the prone compared to the supine position (P = 0.02), while no differences in Xrs, ptcO2, ptcCO2, and breathing pattern were observed between postures. Only patients with evolving BPD showed a significant reduction of Rrs from 69.0 ± 27.4 to 53.0 ± 16.7 cmH2Os/l, P = 0.01. No significant correlations were found between changes in lung mechanics and ptcO2, ptcCO2, or breathing pattern. Conclusions On short-term basis, prone positioning does not offer significant advantages in lung mechanics in mechanically ventilated infants with RDS, while it is associated with lower Rrs values in patients with evolving BPD. Pediatr Pulmonol. 2015; 50:798-804.

Original languageEnglish
Pages (from-to)798-804
Number of pages7
JournalPediatric Pulmonology
Volume50
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

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Mechanics
Premature Infants
Transcutaneous Blood Gas Monitoring
Respiratory System
Lung Diseases
Chronic Disease
Lung
Prone Position
Posture
Respiration
Oxygen
Newborn Respiratory Distress Syndrome
Partial Pressure
Supine Position
Carbon Dioxide
Newborn Infant

Keywords

  • infant pulmonary function
  • mechanical ventilation
  • neonatal pulmonary medicine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease. / Vendettuoli, V.; Veneroni, C.; Zannin, E.; Mercadante, D.; Matassa, P.; Pedotti, A.; Colnaghi, M.; Dellacà, R. L.; Mosca, F.

In: Pediatric Pulmonology, Vol. 50, No. 8, 01.08.2015, p. 798-804.

Research output: Contribution to journalArticle

Vendettuoli, V, Veneroni, C, Zannin, E, Mercadante, D, Matassa, P, Pedotti, A, Colnaghi, M, Dellacà, RL & Mosca, F 2015, 'Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease', Pediatric Pulmonology, vol. 50, no. 8, pp. 798-804. https://doi.org/10.1002/ppul.23049
Vendettuoli, V. ; Veneroni, C. ; Zannin, E. ; Mercadante, D. ; Matassa, P. ; Pedotti, A. ; Colnaghi, M. ; Dellacà, R. L. ; Mosca, F. / Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease. In: Pediatric Pulmonology. 2015 ; Vol. 50, No. 8. pp. 798-804.
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AB - Background The role of prone position in preterm infants has not been completely clarified. We investigated prone versus supine posture-related changes in respiratory system resistance (Rrs) and reactance (Xrs) measured by the Forced Oscillation Technique (FOT) in mechanically ventilated preterm newborns. Methods Patients were studied in the supine versus prone positions in random order. Oxygen saturation, transcutaneous partial pressure of oxygen (ptcO2), carbon dioxide (ptcCO2), Rrs and Xrs were measured in each position. Results Nine patients with respiratory distress syndrome (RDS) and nine with evolving broncho-pulmonary dysplasia (BPD) were studied. Rrs was, on average, 9.8 (1.3, 18.3 as 95%CI) cmH2Os/l lower in the prone compared to the supine position (P = 0.02), while no differences in Xrs, ptcO2, ptcCO2, and breathing pattern were observed between postures. Only patients with evolving BPD showed a significant reduction of Rrs from 69.0 ± 27.4 to 53.0 ± 16.7 cmH2Os/l, P = 0.01. No significant correlations were found between changes in lung mechanics and ptcO2, ptcCO2, or breathing pattern. Conclusions On short-term basis, prone positioning does not offer significant advantages in lung mechanics in mechanically ventilated infants with RDS, while it is associated with lower Rrs values in patients with evolving BPD. Pediatr Pulmonol. 2015; 50:798-804.

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