title: Semi-Prone Position Can Influence Variability in Respiratory Rate of Premature Infants Using Nasal CPAP.
abstract: To determine the effect of positions (supine, lateral, semiprone) on the physiological parameters (HR, RR, SpO2) of premature infants receiving NCPAP who were non-oxygen-dependent and non-BPD, and to identify significant clinical changes associated with these variables.
  
  
  METHODS
  A crossover study design with three different positions in the assigned sequence (supine-supine, supine-lateral and supine-semiprone) was used, and each position was maintained for 1h. The subjects' vital signs were recorded 30 min after initiation of each position and measured for 30 min.
  
  
  RESULTS
  Forty-seven infants with a median GA of 28.6 weeks (range 26-35) were studied, and their median BW was 1210g (range 776-2920). Overall, position-related effects showed significant difference in the variability in RR (OR=0.68; CI 0.51-0.89), with the variability in RR being significantly lower in the semiprone position. The lateral position was associated with increased RR (B=2.9; p=0.02). Previous use of ventilator (PUV) was associated with increased HR, whereas BW and GA were negatively associated with higher HR. Cesarean birth, use of surfactant and PUV were associated with lower SpO2, whereas BW and GA were correlated with higher SpO2. GA was identified as a protective factor, while PUV was a risk factor for the variability in both HR and SpO2.
  
  
  CONCLUSIONS
  Premature infants receiving NCPAP sleeping in the semiprone position may have more stable RR, while the lateral position did not improve RR. Thus, the semiprone and supine positions may be considered preferable when positioning the monitored premature infants with NCPAP.
authors.affiliation: Department of Nursing, Tri-Service General Hospital, Department of Nursing, National Defense Medical Center, Taiwan, R.O.C.
authors.forename: Ti
authors.initials: T
authors.lastname: Yin
authors.affiliation: Department of Pediatrics, Cheng-Hsin Hospital, Department of Pediatrics, National Defense Medical Center, Taiwan, R.O.C.
authors.forename: Yeong-Seng
authors.initials: YS
authors.lastname: Yuh
authors.affiliation: Department of Nursing, National Defense Medical Center, Taiwan, R.O.C.
authors.forename: Jen-Jiuan
authors.initials: JJ
authors.lastname: Liaw
authors.affiliation: Department of Nursing, Taipei Veteran General Hospital, School of Nursing, National Yang-Ming University, Taipei Veteran General Hospital, Taiwan, R.O.C.
authors.forename: Yin-Yin
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Nursing, Mackay Medical College, Taiwan, R.O.C.. Electronic address: kwwang@mmc.edu.tw.
authors.forename: Kai-Wei Katherine
authors.initials: KW
authors.lastname: Wang
mesh_terms: D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D015999:Multivariate Analysis; D056888:Patient Positioning / Q000379:methods; D061214:Patient Safety; D016684:Prone Position; D056152:Respiratory Rate / Q000502:physiology*; D013398:Sudden Infant Death / Q000517:prevention & control*; D016683:Supine Position; D013624:Taiwan
keywords: Nasal continuous positive airway pressure; Neonatology; Patient positioning; Vital signs