Decreased activity and oxygen desaturation in prone ventilated preterm infants during the first postnatal week

OBJECTIVE: To compare the effects of supine and prone positions on oxygen saturation (SpO(2)), desaturation episodes (SpO(2) < 90% and ≥ 20 seconds), and motor activity in ventilated preterm infants during their first postnatal week. DESIGN: With use of a crossover design, we randomly assigned infants to a supine/prone or prone/supine position sequence. Infants were placed in each position for 2 hours. A stabilization period of 10 minutes before observation of each position was allowed. During the protocol, care procedures were kept minimal and ventilator settings remained unchanged. SETTING: Neonatal intensive care units at 2 tertiary care centers in Taiwan. SAMPLE: The sample consisted of 28 infants receiving mechanical ventilation who were 25 to 36 weeks' gestation, without known congenital abnormalities, within 7 postnatal days of birth, and were not receiving sedation. RESULTS: When prone, infants had higher SpO(2), fewer episodes of oxygen desaturation, and less motor activity than when supine. No significant differences in duration of SpO(2) less than 90%, 85%, and 80% were found between the 2 positions. Seventy-four percent of desaturation episodes were associated with vigorous motor activity and crying. CONCLUSION: The prone position results in less motor activity and may stabilize oxygenation for ventilated preterm infants. This may conserve energy and decrease complications of hypoxia for sick preterm infants.