The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants

Authors

  • Karly Montgomery,

    1. Faculty of Health and Medical Sciences, Bond University, Gold Coast, Queensland, Australia
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  • Nancy L Choy,

    1. Faculty of Health and Medical Sciences, Bond University, Gold Coast, Queensland, Australia
    2. School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia
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  • Michael Steele,

    1. Faculty of Business, Bond University, Gold Coast, Queensland, Australia
    2. Department of Mathematics, Faculty of Science, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
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  • Judith Hough

    Corresponding author
    1. School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia
    2. Critical Care of the Newborn Program, Mater Research Institute – The University of Queensland, Brisbane, Queensland, Australia
    • Correspondence: Dr Judith Hough, School of Physiotherapy, Australian Catholic University, 1100 Nudgee Rd, Banyo, QLD 4014, Australia. Fax: (07) 3163 16421; email: Judith.Hough@acu.edu.au

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  • Conflict of interest: The authors have no competing interests.
  • Trial registration: ACTRN12606000210572

Abstract

Aim

The aim of this study was to determine the effectiveness of quarter turn from prone compared with supine and prone positioning in maintaining respiratory function in premature infants managed in a neonatal intensive care unit.

Methods

The study was a prospective, randomised, cross-over trial with concealed allocation and intention to treat analysis. Fifty-four infants ≤32 weeks gestation were randomly allocated to the order of the positions supine, prone and quarter turn from prone. Distribution of ventilation was assessed by measurement of regional impedance amplitude, global inhomogeneity index and phase angle analysis using electrical impedance tomography 30 min after each position change. Physiological characteristics of heart rate, respiratory rate (RR), oxygen saturation and inspired oxygen were also measured.

Results

There was a significant difference between positions for RR with the RR in quarter turn from prone significantly lower than for supine (mean difference 6.53 breaths/min; 2.04–11.02), but not compared with the prone position. No significant differences between positions were found for any of the other outcomes measured.

Conclusion

This study demonstrated that quarter turn from prone had an immediate positive positional effect on the RR of premature infants. The position of quarter turn from prone was comparable with prone in the maintenance of lung function and had a superior effect over supine on RR. These findings support the view that a quarter turn from prone can be confidently used in neonatal nurseries to manage premature infants.

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