Effect of head-elevated prone position care for stable term neonates with tachypnea in transitional period: A randomized controlled trial
Keywords:
Optimum temperature tachypnea, normal infants’ respiratory rate, normal infants’ temperature, term infant, transition periodAbstract
Background: Rapid shallow breathing in 2 - 6 hours after birth or transitional period is usually physiologic. Infants who still have respiratory rate over 60 breaths per minutes after two hours supportive care at Sirindhorn labor room must be admitted as sick newborn. This may cause an unnecessary admission and increase the risk of breastfeeding failure.
Objectives: Primary objective was to evaluate the benefit of prone position in reducing respiratory rate to 60 breaths per minute especially when complete two hours labor room treatment. Secondary objective was to compare the infants’ normal body temperature (36.5 - 37.5 °C) and optimum infants’ body temperature (36.8 - 37.2 °C) caring in different positions at two hours of age.
Methods: Two hundred subjects were randomized into head-elevated prone group and supinepositioned group. The subjects were term Thai neonate with stable tachypnea in transitional period. Both groups were received the same supporting care except for the care positions. The subjects’ respiratory rate and the relation between the duration were monitored and analyzed for normal respiratory rate and difference in positional care.
Results: The duration used for normal respiratory rate in a head-elevated prone group was significantly shorter than a supine-positioned group (P = 0.0004). Head-elevated prone care significantly increased cumulative number of subjects with normal respiratory rate within four hours (P = 0.01) and within six hours (P = 0.002) but no significant increase in cumulative number of subjects with normal respiratory rate within two hours (P = 0.234). At aged two hours, both groups had normothermia but the headelevated prone group had more optimum body temperature range (P = 0.02).
Conclusion: Head-elevated prone position care for stable term neonate with tachypnea in transitional period can significantly decrease infants’ respiratory rate within four hours compared to supine-positioned care.
