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The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography

BACKGROUND: Positioning of ill children is often used to optimise ventilation–perfusion matching, thereby improving oxygenation. OBJECTIVES: To determine the effects of supine and prone positions, and different head positions, on the distribution of ventilation in healthy, spontaneously breathing in...

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Autores principales: Lupton-Smith, Alison, Argent, Andrew, Rimensberger, Peter, Morrow, Brenda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS OpenJournals 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093132/
https://www.ncbi.nlm.nih.gov/pubmed/30135874
http://dx.doi.org/10.4102/sajp.v71i1.237
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author Lupton-Smith, Alison
Argent, Andrew
Rimensberger, Peter
Morrow, Brenda
author_facet Lupton-Smith, Alison
Argent, Andrew
Rimensberger, Peter
Morrow, Brenda
author_sort Lupton-Smith, Alison
collection PubMed
description BACKGROUND: Positioning of ill children is often used to optimise ventilation–perfusion matching, thereby improving oxygenation. OBJECTIVES: To determine the effects of supine and prone positions, and different head positions, on the distribution of ventilation in healthy, spontaneously breathing infants and children between the ages of 6 months and 9 years. METHODS: Electrical impedance tomography measurements were recorded from participants in supine and prone positions. Head positions included the head turned to the left and right in supine and prone positions, and in the midline in the supine position. Distribution of ventilation was described using end-expiratory–end-inspiratory relative impedance change. RESULTS: A total of 56 participants (boys = 31 [55%]; girls = 25 [45%]) were studied. The dorsal lung was significantly better ventilated than the ventral lung (P < 0.001) in both body positions. The majority of participants (83%) had greater ventilation in the dorsal lung in both positions, whilst five participants (10%) demonstrated consistently better ventilation in the non-dependent lung in both positions. Head position had no effect on the distribution of ventilation. CONCLUSIONS: This study demonstrates that the distribution of ventilation in healthy, spontaneously breathing infants and children in supine and prone positions is not as straightforward as previously thought, with no clear reversal of the adult pattern evident.
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spelling pubmed-60931322018-08-22 The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography Lupton-Smith, Alison Argent, Andrew Rimensberger, Peter Morrow, Brenda S Afr J Physiother Observational Study BACKGROUND: Positioning of ill children is often used to optimise ventilation–perfusion matching, thereby improving oxygenation. OBJECTIVES: To determine the effects of supine and prone positions, and different head positions, on the distribution of ventilation in healthy, spontaneously breathing infants and children between the ages of 6 months and 9 years. METHODS: Electrical impedance tomography measurements were recorded from participants in supine and prone positions. Head positions included the head turned to the left and right in supine and prone positions, and in the midline in the supine position. Distribution of ventilation was described using end-expiratory–end-inspiratory relative impedance change. RESULTS: A total of 56 participants (boys = 31 [55%]; girls = 25 [45%]) were studied. The dorsal lung was significantly better ventilated than the ventral lung (P < 0.001) in both body positions. The majority of participants (83%) had greater ventilation in the dorsal lung in both positions, whilst five participants (10%) demonstrated consistently better ventilation in the non-dependent lung in both positions. Head position had no effect on the distribution of ventilation. CONCLUSIONS: This study demonstrates that the distribution of ventilation in healthy, spontaneously breathing infants and children in supine and prone positions is not as straightforward as previously thought, with no clear reversal of the adult pattern evident. AOSIS OpenJournals 2015-05-29 /pmc/articles/PMC6093132/ /pubmed/30135874 http://dx.doi.org/10.4102/sajp.v71i1.237 Text en © 2015. The Authors http://creativecommons.org/licenses/by/2.0/ Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License.
spellingShingle Observational Study
Lupton-Smith, Alison
Argent, Andrew
Rimensberger, Peter
Morrow, Brenda
The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title_full The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title_fullStr The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title_full_unstemmed The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title_short The effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
title_sort effects of prone and supine positions on the regional distribution of ventilation in infants and children using electrical impedance tomography
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093132/
https://www.ncbi.nlm.nih.gov/pubmed/30135874
http://dx.doi.org/10.4102/sajp.v71i1.237
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