An approach to define newborns´ sniffing position using an angle based on reproducible facial landmarks

Autor:	Christian F. Poets, Bianca Haase, Laila Springer, Bernd Koos, Ana-Maria Badinska
Rok vydání:	2021
Předmět:	Orthodontics Reproducibility Mask ventilation Supine position Head (linguistics) business.industry Sniffing position Posture Infant Newborn Infant Reproducibility of Results Airway obstruction medicine.disease Sagittal plane Airway Obstruction Anesthesiology and Pain Medicine medicine.anatomical_structure Sniffing Pediatrics Perinatology and Child Health medicine Humans Prospective Studies business Head psychological phenomena and processes
Zdroj:	Pediatric Anesthesia. 31:404-409
ISSN:	1460-9592 1155-5645
Popis:	Background The neutral or sniffing position is advised for mask ventilation in neonates to avoid airway obstruction. As definitions are manifold and often unspecific, we wanted to investigate the reliability and reproducibility of angle measurements based on facial landmarks that may be used in future clinical trials to determine a hypothetical head position with minimal airway obstruction during mask ventilation. Methods In a prospective single-center observational study, 2D sagittal photographs of 24 near-term and term infants were taken, with five raters marking facial landmarks to assess interobserver agreement of those landmarks and angle δ, defined as the angle between the line parallel to the lying surface and the line crossing Subnasale (Sn) and Porion' (P'). Angle δ was assessed in sniffing (δsniff ) and physiologic (δphys ) head position, the former based on a published, yet poorly defined head position where the tip of the nose aligns to the ceiling with the head in a supine, relaxed mid-position. Results Infants had a mean (SD) gestational age of 37.3 (2.3) weeks. Angle δ could be determined in all 48 images taken in either the sniffing or the physiological head position. Interobserver correlation coefficient was 98.6 for all measurements independent of head position. Angle δsniff was 90.5° (5.7) in the sniffing position. Conclusions This study provides a new measuring technique using an angle that is reproducible and reliable and may be used in future studies to correlate head position with airway obstruction.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fe76c833c5032c811aefd9d7b58b7595 https://doi.org/10.1111/pan.14154 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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