[Effect of position on oxygenation in neonates after weaning from mechanical ventilation]

What is the best suitable position for neonates who were weaned from mechanical ventilation has not been identified. This study aimed to evaluate the effect of the supine and prone positions on oxygenation in neonates within 6 hrs after weaning from mechanical ventilation.Sixty neonates who were weaned from mechanical ventilation were randomly given prone or supine position (n=30 each). They all received oxygen inspiration and SPO2 was maintained in a normal range by adjusting the oxygen flow rate (FiO2). Blood PaO2 and PaCO2 levels were measured 1 and 6 hrs after weaning and then the alveolodouble ended arrowarterial oxygen partial pressure difference (A-aDO2), respiratory index and oxygenation index were calculated.Mean FiO2 used in the prone position group was significantly lower than that in the supine position group 1 and 6 hrs after weaning (P0.01). The value of A-aDO2 in the prone position group 1 hr (171.06+/-86.55 vs 253.62+/-71.56; P0.01) and 6 hrs after weaning (105.85+/-78.18 vs 208.48+/-86.80; P0.01) were significantly lower than that in the supine position group. The respiratory index in the prone position group 1 and 6 hrs after weaning (2.16+/-1.24 and 1.35+/-1.11) was also reduced compared to 3.74+/-1.68 and 3.65+/-1.28 in the supine position group (P0.01). In contrast, PaO2 in the prone position group 1 hr (88.70+/-32.65 vs 73.43+/-17.68; P0.01) and 6 hrs (84.10+/-13.95 vs 70.20+/-20.27; P0.01) after weaning was significantly higher than that in the supine position group. The oxygenation index in the prone position group 1 and 6 hrs after weaning (213.49+/-88.96 and 275.23+/-108.83) increased significantly compared to 141.54+/-43.25 and 160.62+/-63.03 in the supine position (P0.01).The prone position is better than the supine position for the improvement of oxygenation within 6 hrs after weaning from mechanical ventilation in neonates.