Effect of Prone Positioning on Ventilation in Preterm Neonates - A Randomized Controlled Trial.

OBJECTIVES: To determine the effect of prone positioning on the duration of respiratory support in neonates receiving non-invasive mode of ventilation. METHODS: This open label randomized controlled trial was conducted in the NICU of a tertiary care hospital. Preterm neonates who fulfilled the eligibility criteria for enrolment were included within 6 h of starting non-invasive respiratory support. Neonates in intervention group were given respiratory support in the prone position. After every 90 min of prone positioning, the position was changed to side lying/supine position for 30 min in the intervention group. The comparator group were given respiratory support in the supine position with 2 hourly changes in position (supine-side lying-prone). The primary outcome was duration of non-invasive ventilation. RESULTS: Duration of non-invasive ventilation did not reduce in the intervention group. {[h; 80 (36 to 127) vs. 93.5 (42 to 142)], median difference (h) -8, 95% CI: -30 to 13, p = 0.47} Neonates in the prone group had significantly lower peak FiO2 requirements [30 (30–30) vs. 35 (30–50), p = 0.01] and frequency of apnea [episodes per day; 0.4 (0.2–1) vs. 1 (0.4–1.6), p = 0.04]. CONCLUSIONS: Prone positioning did not reduce the duration of non-invasive respiratory support in preterm neonates. CLINICAL TRIAL REGISTRATION: CTRI/2021/10/037183