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Effect of Change in Newborn’s Position during Mechanical Ventilation on Oxygenation

Background: Acute respiratory failure remains an important cause of morbidity and mortality in children. In the last few years great attention was paid to the effect of changes in infant’s position other than the supine position during mechanicall ventilation. Objective: To evaluate the effect of position change on oxygenation in newborn infants during mechanical ventilation in neonatal intensive care unit (NICU). Methods: This study was across- section study, which was done on 74 obese children aged 6-18 years. This study was done at Pediatrics Department, Zagazig University Hospitals, during the period from 2017 to 2018. The cases were divided into two groups, group A included newborn infants using ventilators in supine position (supine group) and group B included newborn infants in supine position alternating with prone position (alternate group). All children were subjected to history talking and clinical examination. Anthropometric measurements were measured. In addition, carotid intima-media thickness quantification was estimated. Results: There were statistically significant decrease in VT (ml) at (8 hr and 16 hr) among alternate group than supine group. In addition, OI and PaO2, at 8 and 16 h in alternate position groups were higher than those in supine position group were. There were statistically significant decrease in PEEP (cm H2O) at 8 hour among supine group than alternate group. There was no statistically significant difference between supine group and alternate group regarding PEEP (cm H2O) at 16 hour. This study showed that, There were statistically significant decrease in PaO2 (mm Hg) at (8 hr and 1 hr drawl) among supine group than alternate group. There was no statistically significant difference between supine group and alternate group regarding PaO2 (mm Hg) at 16 hr. Conclusion: Oxygenation and respiratory mechanics were significantly improved in prone position group than those in supine position group. The physiological basis of prone positioning seems to act beneficially improving hemodynamics, gas exchange and respiratory mechanics.