Response of oxygen saturation in preterm infants receiving rib cage stabilization with an elastic band in two body positions: a randomized clinical trial

Abstract

| Background: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. Objective: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. Method: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. Results: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. Conclusion: The use of an elastic chest band improves respiratory indicators such as oxygen saturation.Keywords: respiratory mechanics; preterm newborn; supine position; prone position; movement. Article registered in Registro Brasileiro de Ensaios Clinicos (ReBEC) under number RBR-7wm8mz. HOW TO CITE THIS ARTICLEBrunherotti MAA, Martinez FE. Response of oxygen saturation in preterm infants receiving rib cage stabilization with an elastic band in two body positions: a randomized clinical trial. Braz J Phys Ther.

Effects of Hammock Positioning on Clinical Parameters in Preterm Infants Admitted to a Neonatal Intensive Care Unit: A Systematic Review

“…Previous studies have shown that different positions positively influence PTNBs, contributing to lower energy expenditure, improved oxygenation, reduced episodes of gastroesophageal reflux and lower thoracoabdominal asynchronism. 28,29 Many devices, both artisanal and commercial, are available to assist in this positioning, favoring body flexion, including nest and hammock positioning, a fact documented here. 30 Although therapeutic positioning is considered a to be a common management practice within the NICU, it can alternate in decubitus, depending on the location, the therapeutic resource and the underlying pathology.…”

“…24 Some studies carried out in children and adults have shown greater benefits in saturation and partial oxygen pressure in the prone position compared to supine, with this improvement being more evident in the presence of lung disease. 29,[31][32][33] This could explain the fact of the worsening treatment of PTNB in the study by Zanardo et al 24 , as the patients were positioned in supine in this intervention. Furthermore, it is known that a ventilatory strategy to minimize lung injury in bronchopulmonary dysplasia is the use of the prone position, which is different from the position used by its sample.…”

Effect of Positioning on Respiratory System Function of Preterm Neonate with Respiratory Distress Syndrome

“…Preterm neonates have higher thoracic compliance which provides less stability to the different forces of the distortion imposed on the rib cage, leading to chest instability. Appropriate body position may reduce this instability and facilitate respiratory work (Brunherotti & Martinez, 2013) The common practice for preterm infants in a neonatal intensive care unit or special care unit should be in a prone position for >50% of the time, recognizing that respiratory function and oxygenation improves in the prone sleeping position (Balaguer et al, 2013).…”

Does Neurophysiological Facilitation (NPF) influence respiratory function in a preterm infant with respiratory distress? A Case Report

“…15 The proprioceptive feedback originating from respiratory muscles may regulate medullary respiratory centers in the brain through the motor activity of long loop reflexes. 15,16 Studies have shown that the administration of NPF on adult ventilated patients improved their ventilation capacity and oxygen saturation levels. 17,18 However, there are no studies published to see the effect of NPF in preterm infants.…”