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Evidence summaries

Positioning for Acute Respiratory Distress in Hospitalised Infants and Children

In ventilated, preterm infants the prone positioning appears to improve respiratory function. Since prone positioning has been associated with sudden infant death syndrome, it can be recommended only when continuous cardiorespiratory monitoring is used. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 24 studies with a total of 581 subjects. These studies compared prone, supine, lateral, elevated, and flat positions. Prone positioning was significantly more beneficial than supine positioning in terms of oxygen saturation, arterial oxygen, episodes of hypoxaemia, and thoraco-abdominal synchrony. There were no statistically significant differences between any other positions.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment).

    References

    • Gillies D, Wells D, Bhandari AP. Positioning for acute respiratory distress in hospitalised infants and children. Cochrane Database Syst Rev 2012;(7):CD003645. [PubMed]

Primary/Secondary Keywords