Clinical application of ventilation in prone position in treatment of neonatal acute respiratory distress syndrome

Objective To observe application effect of ventilation in prone position in treatment of neonatal acute respiratory distress syndrome (NARDS).

Methods A total of 46 neonates with NARDS were retrospectively selected as study objects, among whom 20 cases with ventilation in prone position(mainly using prone position, and alternatively using lateral position) were included in prone position group, while 26 cases ventilated in conventional supine position were selected as supine position group. Arterial partial pressure of oxygenp_a(O₂) to inhaled oxygen fraction (FiO₂) ratio (P/F) and oxygenation index of two groups of neonates at beginning of mechanical ventilation, and 4, 24, 48 and 72 h after mechanical ventilation were compared. The number of using pulmonary surfactant (PS) during treatment, mechanical ventilation time, total oxygen use time and length of hospital stay were observed, the incidence rates of related complications and the mortality during treatment were compared.

Results The p_a(O₂) and P/F values of the neonates in the prone position group were higher than those of the supine position group, and the OI value was lower than that of the supine position group at 4, 24, 48 and 72 h after mechanical ventilation (P < 0.05); arterial partial pressure of carbon dioxidep_a(CO₂) after 72 h of mechanical ventilation was lower than that of the supine position group(P < 0.05). The total oxygen consumption time in the prone position group was shorter than that in the supine position group(12.53±3.48) d versus (15.60±4.46) d, P < 0.05. There were no significant differences in number of pulmonary surfactant usage, mechanical ventilation time and hospital stay (P>0.05). The incidence rates of neonatal persistent pulmonary hypertension, mortality, and complications between the two groups showed no significant differences(P>0.05).

Conclusion Prone position mechanical ventilation can effectively improve the oxygenation and respiratory function of neonates with NARDS, shorten the time of oxygen use, and does not increase the occurrence of related complications.