Prone Positioning Was Associated With Less Hypoxemic Events and Improved Feeding Tolerance in Preterm Infants.

AIM: Cardiorespiratory events such as apnea, bradycardia and hypoxemia are common in preterm infants and may contribute to an impaired neurodevelopmental outcome. We hypothesised a significant reduction in the incidence of hypoxemia, bradycardia and gastric residuals in the prone position.

METHODS

In this monocentric, prospective, randomised, two-arm crossover trial, at a tertiary university hospital, 48 preterm infants with a gestational age of < 32 weeks and a postmenstrual age of < 34 weeks were randomised to either a prone-supine or a supine-prone sequence of cardiorespiratory monitoring over a period of 24 h. The primary outcome parameter was the cumulative frequency of hypoxemias and bradycardias; secondary parameters comprised evaluation of basal parameters, hypoxemias, bradycardias and the amount of gastric residuals.

RESULTS

The cumulative frequency of hypoxemias and bradycardias and the number of severe hypoxemias (peripheral oxygen saturation [SpO2] < 80%) were halved in the prone position (p = 0.03). Median basal SpO2 was significantly higher (p = 0.01) and gastric residuals were significantly lower (p = 0.0002) in the prone position. The frequency of apneas (> 10 s) was significantly increased in the prone position (p = 0.01).

CONCLUSION

Prone positioning of preterm infants significantly reduces the cumulative frequency of hypoxemias and bradycardias, severe hypoxemias and gastric residuals while increasing basal SpO2.