Effect of prone position ventilation mode and ventilation time on pulmonary compliance and rehabilitation of mechanically ventilated neonates
WANG Feifei
LU Pinpin
WENG Xiaowen
Abstract：Objective To investigate the effects of prone position ventilation mode and ventilation time on pulmonary compliance and rehabilitation outcomes in mechanically ventilated neonatal with acute respiratory distress syndrome(NARDS).Methods A total of 90 newborns with NARDS and received mechanical ventilation between November 2022 and May 2023 were included as the study subjects.They were randomly divided into two groups using a digital table method:supine group(n=30)and prone group(n=60).The prone group was sub-divided into a 2-hour prone group(n=30)and a 3-hour prone group(n=30).Neonates in all three groups were given routine interventions.Mechanical ventilation in the prone position and supine position was respectively adopted in the prone and supine groups.In the 2-hour and 3-hour prone groups,neonates were turned over once every 2 hours for 3 times a day,and every 3 hours for 4 times a day,respectively.General conditions,blood gas indicators,respiratory dynamics indicators,and chest lung compliance indicators were compared among the three groups.Results There were no significant differences in the arterial oxygen saturation(SaO2),partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)and oxygen index(OI)among the three groups before ventilation(P＞0.05).At 12 hours and 72 hours of ventilation,SaO2,PaO2,and OI significantly increased,while PaCO2 significantly decreased in all the three groups.SaO2,PaO2,and OI were significantly higher in the 3-hour prone group,followed by the 2-hour prone group and supine group,and PaO2 was the lowest in the 3-hour prone group,followed by the 2-hour prone group and supine group(P＜0.05).Before ventilation,there were no significant differences in the mean arterial pressure(MAP),peak inspiratory pressure(PIP),airway resistance(Raw),and static compliance among the three groups(P＞0.05).At 12h and 72h of ventilation,the static compliance significantly increased,while the MAP,PIP and Raw significantly decreased in all the three groups(P＜0.05).The static compliance was significantly higher in the 3-hour prone group,followed by the 2-hour prone group and supine group,and MAP,PIP and Raw were the lowest in the 3-hour prone group,followed by the 2-hour prone group and supine group(P＜0.05).Mechanical ventilation time,total hospitalization time,and milk opening time were the shortest in the 3-hour prone group,followed by the 2-hour prone group and supine group(P＜0.05).Daily increase in milk volume during ventilation was significantly higher in the 3-hour prone group,followed by the 2-hour prone group and supine group(P＜0.05).All patients of the three groups did not experience severe complications such as intracranial hemorrhage,ventilator-associated pneumonia,and pneumothorax.Conclusion Prone position ventilation can better improve the oxygenation function of mechanically ventilated neonates with NARDS,shorten the duration of mechanical ventilation and hospitalization,help start breastfeeding early and increase milk volume.It is safe and reliable.Ventilating in a prone position for 3 hours and turning over once a day for 12 hours can better improve the effectiveness of mechanical ventilation in pediatric patients.
Keywords：newbornacute respiratory distress syndromemechanical ventilationposition managementpulmonary compliancepulmonary rehabilitation
Publication Date：2025-08-26
Online Publishing Date：2025-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 1297-1300,1305 )