Effect of Supine and Prone Positions on Arterial Oxygen Tension in the Preterm Infant

PEDIATRICS ◽  
1979 ◽  
Vol 63 (4) ◽  
pp. 528-531 ◽  
Author(s):  
Richard J. Martin ◽  
Nancy Herrell ◽  
Dov Rubin ◽  
Avroy Fanaroff
Keyword(s):  
Intensive Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Prone Position ◽  
Oxygen Tension ◽  
Neonatal Intensive Care ◽  
Arterial Oxygen Tension ◽  
Arterial Oxygen ◽  
Sleep State ◽  
Optimal Position

To determine the optimal position for the preterm infant, arterial oxygen tension (Pao2) was monitored in 16 preterm infants by the transcutaneous method with the infants in both supine and prone positions. When the infants were prone, Pao2 rose by a mean of 7.4 mm Hg (P < .001), an increase of 15%. In those infants with residual cardiopulmonary disease, a 25% increase was noted. The higher Pao2 in the prone position was accompanied by a significant decrease in the amount of time the chest wall moved asynchronously. This improved oxygenation in the prone position appears to be the result of enhanced ventilation/ perfusion ratios and not merely secondary to an alteration in sleep state with positioning of the infant. These findings may have important implications in the management of preterm infants requiring neonatal intensive care.

PERIODIC BREATHING AND APNEA IN PRETERM INFANTS. II. HYPOXIA AS A PRIMARY EVENT

PEDIATRICS ◽  
1972 ◽  
Vol 50 (2) ◽  
pp. 219-228
Author(s):  
Henrique Rigatto ◽  
June P. Brady
Keyword(s):  
Preterm Infants ◽  
Oxygen Tension ◽  
Minute Ventilation ◽  
Arterial Oxygen Tension ◽  
Blood Gases ◽  
Periodic Breathing ◽  
Capillary Blood ◽  
Arterial Oxygen ◽  
Primary Event ◽  
The Relationship

We studied nine healthy preterm infants during the first 35 days of life to define the relationship between periodic breathing, apnea, and hypoxia. For this purpose we compared ventilation/apnea (V/A), minute ventilation, and alveolar and capillary blood gases during periodic breathing induced by hypoxia and during spontancous periodic breathing in room air. We induced periodic breathing by giving the baby in sequence 21, 19, 17, and 15% O2 to breathe for 5 minutes each, and also by giving 21, 15, and 21% O2. We measured ventilation with a nosepiece and a screen flowmeter. With a decrease in arterial oxygen tension, preterm infants (1) hypoventilated, (2) breathed periodically more frequently, and (3) showed a decrease in V/A due to an increase in the apneic interval. In one baby this led to apnea lasting 30 seconds. These findings support our hypothesis that preterm infants breathing periodically hypoventilate and suggest that hypoxia may be a primary event leading to periodic breathing and apnea.

POSITIVE TRANSPULMONARY AIRWAY PRESSURE

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 175-177
Author(s):  
Thomas K. Oliver
Keyword(s):  
Neonatal Mortality ◽  
Oxygen Tension ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Arterial Oxygen Tension ◽  
Good Evidence ◽  
Arterial Oxygen ◽  
Management Scheme ◽  
Idiopathic Respiratory Distress Syndrome ◽  
Adequate Oxygenation

There is now good evidence unpublished and published1,2 that neonatal intensive care is associated with increased survival. The major cause of neonatal mortality is the idiopathic respiratory distress syndrome (IRDS); hence the decrease in neonatal mortality can be ascribed, in part at least, to improvement in the management of infants with this syndrome. The arterial oxygen tension while breathing 100% oxygen has been shown to be the most valuable prognosticator for outcome in this disease;3,4 an oxygen tension less than 100 mm Hg (in 100% oxygen) during the first 24 hours is associated with a markedly increased mortality. Thus central in the management scheme is adequate oxygenation.

Kangaroo Baby Care: Just a Nice Experience or an Important Advance for Preterm Infants?

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 604-605
Author(s):  
ANDREW WHITELAW
Keyword(s):  
Intensive Care ◽  
Home Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Developed Countries ◽  
Important Advance ◽  
Skin Contact ◽  
Skin To Skin

"Kangaroo baby care" or "skin-to-skin contact" describes the practice of holding a preterm infant naked (except for a diaper) between the mother's breasts. The baby's face pokes out of the top of the mother's dress like a baby kangaroo's. Rey and Martinez in Bogota, Colombia1 pioneered the home care of premature infants as small as 1000 g, the mother being taught to hold her baby head-up kangaroo-style to encourage lactation, prevent aspiration, and reduce rejection. Education and motivation of the mother in the care of preterm infants makes obvious sense in the developing world, but kangaroo baby care has also been applied in many developed countries in conjunction with neonatal intensive care rather than as a replacement for incubators and monitors.2-4

scholarly journals Effect of nursing position on incidence, type, and duration of clinically significant apnoea in preterm infants.

1994 ◽  
Vol 71 (1) ◽  
pp. F16-F19 ◽  
Author(s):  
L O Kurlak ◽  
N R Ruggins ◽  
T J Stephenson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Infants ◽  
Prone Position ◽  
Neonatal Intensive Care ◽  
Initial Position ◽  
Nasal Airflow ◽  
Respiratory Effort ◽  
Clinically Significant ◽  
Electrocardiogram Ecg

AIM--To investigate whether nursing position has any effect on the frequency, type, and duration of apnoeas in preterm infants. METHOD--Thirty five preterm infants were entered into a crossover study and underwent polygraphic monitoring in each of two positions, prone and supine, the initial position being randomly allocated. Four parameters were recorded: nasal airflow, respiratory effort, electrocardiogram (ECG), and oxygen saturation. Each infant was studied in the two positions on the same day and each infant was studied only once. The studies were carried out on the neonatal intensive care unit. RESULTS--The infants were found to have significantly more central and mixed apnoeas in the supine than in the prone position. In addition, the severity of mixed apnoeas in terms of the duration of accompanying bradycardias and desaturations was greater in the supine than in the prone position (median difference 5.1 seconds in both instances). When considering the type of apnoea in relation to the duration, it was found that of those less than 20 seconds in duration there was a greater proportion that were central (25%) compared with the proportion of central (5%) apnoeas that were longer than 20 seconds. Of all the apnoeas that were less than 20 seconds in length, 16% were obstructive and 59% were mixed, whereas of the apnoeas greater than 20 seconds, 13% were obstructive and 82% were mixed. CONCLUSIONS--It appears that in addition to improving measures of lung function, the adoption of the prone nursing position for preterm infants may reduce associated problems of apnoea of prematurity.

Premature Infant Massage in the NICU

2003 ◽  
Vol 22 (3) ◽  
pp. 39-45 ◽  
Author(s):  
Jodi Beachy
Keyword(s):  
Intensive Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Care Setting ◽  
Massage Therapy ◽  
Intensive Care Setting ◽  
Parenting Skills ◽  
Infant Massage ◽  
Developmental Care

Infant massage therapy is an inexpensive tool that should be utilized as part of the developmental care of the preterm infant. Nurses have been hesitant to begin massage therapy for fear of overstimulating the infant and because there has been insufficient research to prove its safety. Recent research, however, has shown that the significant benefits of infant massage therapy far outweigh the minimal risks. When infant massage therapy is properly applied to preterm infants, they respond with increased weight gains, improved developmental scores, and earlier discharge from the hospital. Parents of the preterm infant also benefit because infant massage enhances bonding with their child and increases confidence in their parenting skills. This article discusses the benefits and risks of massage for preterm infants and their families and explains how to implement massage therapy in the neonatal intensive care setting.

scholarly journals New technique for servo-control of arterial oxygen tension in preterm infants.

1979 ◽  
Vol 54 (4) ◽  
pp. 278-280 ◽  
Author(s):  
I R Beddis ◽  
P Collins ◽  
N M Levy ◽  
S Godfrey ◽  
M Silverman
Keyword(s):  
Preterm Infants ◽  
Oxygen Tension ◽  
Arterial Oxygen Tension ◽  
Servo Control ◽  
New Technique ◽  
Arterial Oxygen
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