Skip to main navigation menu Skip to main content Skip to site footer
Padjadjaran of Nursing Journal

Original

Vol. 9 No. 1 (2021): Jurnal Keperawatan Padjadjaran

Prone Position Improve Physiological Parameters of Preterm Infants Weaning from CPAP: A Randomized Control Trial

DOI
https://doi.org/10.24198/jkp.v9i1.1609
Submitted
January 29, 2021
Published
2021-04-01

Abstract

The need for continuous positive airway pressure (CPAP) was vital for preterm infant with respiratory distress, but the impact of long-term use was very harmful. The effort to do weaning must be done and facilitate the infant to adapt wean off CPAP. The effect of positioning on stabilized physiological parameters may help preterm infant to adapt under gradual weaning from CPAP. Aim in this study to determine the effect of prone positioning on physiological parameters in preterm infants under gradual weaning CPAP. From Mei to September 2020 total sample 60 preterm infants on non-invasive ventilation or CPAP were randomized into prone position (intervention group, n = 30) and supine position (control group, n = 30). Oxygen saturation, respiratory and heart rate between groups were compared. In the prone position was significant higher than supine position at 30th minute. The mean oxygen saturation in the prone position (99.87±0.35) was higher than in the supine position (97.63±1.45; p=0.001), the mean respiratory rate in the prone position (42.10±8.59 breaths/min) was lower than in the supine position (53.20±6.24 breaths/min; p=0.001), and the mean heart rate in the prone position (144.63±13.07/beats/min) was lower than in the supine position (153.53±10.02/beats/min; p=0.001), so that the prone position can be applied to increase oxygen saturation and to maintain the stability of respiratory rate in preterm infants during gradual weaning. The failure to wean off CPAP (re-CPAP) in the prone group was less frequent which is 3 respondents (5% versus 10%). However, there is no relation between positioning and re-CPAP (p=0.472).

Article Matrics
Abstract views : 637 times PDF Downloads: 840

Downloads

Download data is not yet available.

References

  1. Abdel-Hady, H., Shouman, B., & Nasef, N. (2015). Weaning preterm infants from continuous positive airway pressure: evidence for best practice. World Journal of Pediatrics, 11(3), 212-218. https://doi.org/10.1007/s12519-015-0022-6.
  2. Abdeyazdan, Z., Nematollahi, M., Ghazavi, Z., & Mohhamadizadeh, M. (2010). The effects of supine and prone positions on oxygenation in premature infants undergoing mechanical ventilation. Iranian Journal of Nursing and Midwifery Research, 15(4), 229-233. Retrieved December 23, 2020, from http://www.ncbi.nlm.nih.gov/pubmed/22049286%0A
  3. Amatya, Shaili, Rastogi, D., Bhutada, A., & Rastogi, S. (2014). Weaning of nasal CPAP in preterm infants: Who, when and how? A systematic review of the literature. World Journal of Pediatric, 11(1):7-13. https://doi.org/10.1007/s12519-014-0535-4
  4. Babaei, H., Mohammadi Pirkashani, L., & Soleimani, B. (2019). omparison of the effect of supine and prone positions on physiological parameters of preterm infants under nasal continuous positive airway pressure (N-CPAP): A cross over clinical trial. Cukurova Medical Journal, 44(4), 1250-1255. https://doi.org/10.17826/cumj.512192
  5. Baker, B. (2015). Evidence-based practice to improve outcomes for late preterm infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 44(1), 127-134. https://doi.org/10.1111/1552-6909.12533
  6. Boxwell, G. (2010). Neonatal intensive care nursing 2nd ed. Routledge.
  7. Chawla, S., Natarajan, G., Shankaran, S., Carper, B., Gantz, M. G., Das, A., Ronald, N. (2017). Markers of successful extubation in extremely preterm infants, and morbidity after failed extubation. HHS Public Access. US: Hospitals of Leicester. https://doi.org/10.1016/j.jpeds.2017.04.050
  8. Committee on Fetus and Newborn. (2014). Respiratory support in preterm infants at birth. Pediatrics, 133(1), 171-174. https://doi.org/10.1542/peds.2013-3442
  9. Dahlan, M.S. (2016). Besar sampel dalam penelitian kedokteran dan kesehatan, seri 2 (Edisi 4). Epidemiologi Indonesia.
  10. Dargaville, P. A., Aiyappan, A., De Paoli, A. G., Dalton, R. G. B., Kuschel, C. A., Kamlin, C. O., Davis, P. G. (2013). Continuous positive airway pressure failure in preterm infants: Incidence, predictors and consequences. Neonatology, 104(1), 8-14. https://doi.org/10.1159/000346460
  11. Dunn, M.S., Kaempf, J., de Klerk A, de Klerk R, Reilly M., Howard D., Ferrelli K., O’Conor J, Soll R.F., Vermont Oxford Network DRM Study Group. (2011). Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics,128(5):e1069-e1076. https://doi.org/10.1542/peds.2010-3848
  12. Efendi, D., Sari, D., Riyantini, Y., Anggur, D., & Lestari, P. (2019). Pemberian posisi (positioning) dan nesting pada bayi prematur : evaluasi implementasi perawatan di neonatal intensive care unit (NICU). JKI, 22(3),169-181. https://doi.org/10.7454/jki.v22i3.619
  13. Emaliyawati, E., Fatimah, S., & Lidya, L. (2018). Pengaruh Terapi Musik Lullaby terhadap Heart Rate, Respiration Rate, Saturasi Oksigen pada Bayi Prematur. Jurnal Keperawatan Padjadjaran, 5(3). https://doi.org/10.24198/jkp.v5i3.648
  14. Ghorbani, F., Asadollahi, M., & Valizadeh, S. (2013). Comparison the effect of sleep positioning on cardiorespiratory rate in noninvasive ventilated premature infants. Nursing and Midwifery Studies, 1(4), 182-187. https://doi.org/10.5812/nms.10318
  15. Güler, F. & Çalışır, H. (2020). The effect of positioning on adaptation to spontaneous breathing in premature infants after weaning from mechanical ventilation: a randomized controlled trial. The Journal of Pediatric Research, 7(2),102-109. https://doi.org/10.4274/jpr.galenos.2019.19042
  16. Hendrawati, S., Fatimah, S., Fitri, R., Nurhidayah, I. (2017). Kajian Kebutuhan Family Centered Care dalam Perawatan Bayi Sakit Kritis di Neonatal Intensive Care Unit. Jurnal Keperawatan Padjadjaran, 5(2). https://doi.org/10.24198/jkp.v5i2.453
  17. Ho, J.J., Subramaniam, P, Davis, P.G. (2020). Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants. Cochrane Database Systematic Review,(10), 1-40. https://doi.org/10.1002/14651858.CD002271
  18. Hough, J., Trojman, A., & Schibler, A. (2016). Effect of time and body position on ventilation in premature infants. Pediatric Research, 80(4), 499-504. https://doi.org/10.1038/pr.2016.116
  19. Lam, R., Schilling, D., Scottoline, B., Platteau, A., Niederhausen, M., Lund, K. C., McEvoy, C. T. (2019). The effect of extended continuous positive airway pressure on changes in lung volumes in stable premature infants: A randomized controlled trial. The Journal of Pediatrics, 1-8. https://doi.org/10.1016/j.jpeds.2019.07.074
  20. Maffei, G., Gorgoglione, S., & Vento, G. (2017). Noninvasive ventilation: Systematic approach and new perspectives for preterm infants. Journal of Clinical Neonatology, 6(3), 135. https://doi.org/10.4103/jcn.jcn_121_16
  21. Malagoli, R.C., Fagundes, F., Santos, A., Oliveira, E. A., Cândida, M., & Bouzada, F. (2012). Influence of prone position on oxigenation, respiratory rate and muscle strength in preterm infants being weaned from mechanical ventilation. Rev Paul Pediatr, 30(22), 251-6251. https://doi.org/10.1590/S0103-05822012000200015
  22. Montgomery, K., Choy, N. L., Steele, M., & Hough, J. (2014). The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants. Journal of Paediatrics and Child Health, 50(12), 972-977. https://doi.org/10.1111/jpc.12689
  23. Rastogi, S., Rajasekhar, H., Gupta, A., Bhutada, A., Rastogi, D., & Wung, J.-T. (2012). Factors affecting the weaning from nasal CPAP in preterm neonates. International Journal of Pediatrics, 12(1), 1-7. https://doi.org/10.1155/2012/416073
  24. Torabian, H., Alinejad, S., Bayati, A., Rafiei, F., & Khosravi, S. (2019). Comparison of the effects of supine and prone positions on oxygen saturation and vital signs in premature infants: A crossover clinical trial. Iranian Journal of Neonatology, 10(2), 30-36. https://doi.org/10.22038/ijn.2019.32928.1465
  25. Wright, C. J., Sherlock, L., Sahni, R., & Polin, R. A. (2018). Preventing CPAP failure: Evidence-Based and physiologically sound practices from delivery room to the NICU. Clinical Perinatology, 176(1), 139-148. https://doi.org/10.1016/j.clp.2018.01.011