Cerebral Oxygenation and Perfusion when Positioning Preterm Infants: Clinical Implications
| Autor: | Karen A. Waters, Murray Hinder, Lorraine Wakefield, Pranav Jani, Traci Anne Goyen, Claire Galea, Robert Halliday, Nadia Badawi, Krista Lowe, Mark Tracy, Aldo Perdomo |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Supine position Hypoxemia 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Intensive Care Units Neonatal mental disorders Prone Position Supine Position Medicine Humans 030212 general & internal medicine Prospective Studies Cerebral perfusion pressure Hypoxia Brain Bronchopulmonary Dysplasia Cross-Over Studies Continuous Positive Airway Pressure business.industry Infant Newborn Oxygen Inhalation Therapy Brain Oxygenation medicine.disease Oxygen Prone position Intraventricular hemorrhage Bronchopulmonary dysplasia Cerebrovascular Circulation Pediatrics Perinatology and Child Health Cardiology medicine.symptom business Perfusion Infant Premature |
| Zdroj: | The Journal of pediatrics. 235 |
| ISSN: | 1097-6833 |
| Popis: | To evaluate cerebral tissue oxygenation (cTOI) and cerebral perfusion in preterm infants in supine vs prone positions.Sixty preterm infants, born before 32 weeks of gestation, were enrolled; 30 had bronchopulmonary dysplasia (BPD, defined as the need for respiratory support and/or supplemental oxygen at 36 weeks of postmenstrual age). Cerebral perfusion, cTOI, and polysomnography were measured in both the supine and prone position with the initial position being randomized. Infants with a major intraventricular hemorrhage or major congenital abnormality were excluded.Cerebral perfusion was unaffected by position or BPD status. In the BPD group, the mean cTOI was higher in the prone position compared with the supine position by a difference of 3.27% (P = .03; 95% CI 6.28-0.25) with no difference seen in the no-BPD group. For the BPD group, the burden of cerebral hypoxemia (cumulative time spent with cTOI55%) was significantly lower in the prone position (23%) compared with the supine position (29%) (P .001). In those without BPD, position had no effect on cTOI.In preterm infants with BPD, the prone position improved cerebral oxygenation and reduced cerebral hypoxemia. These findings may have implications for positioning practices. Further research will establish the impact of position on short- and long-term developmental outcomes. |
| Databáze: | OpenAIRE |
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