Comparison of Prone Positioning and Chest Physiotherapy on Duration of Intubation in Premature Infants Admitted to Neonatal Intensive Care Unit:A randomized clinical trial

Background: Respiratory distress is one of the most important causes of admitting premature infants to Neonatal Intensive Care Unit (NICU). This condition is an influential factor in relation to ventilation and oxygen supply to the tissue.Objective: This study aimed to compare the effects of prone positioning and chest physiotherapy on duration of intubation in premature infants.Patient and Methods: This randomized clinical trial was done on 69 premature infants under the ventilator who were hospitalized in NICU of Shiraz Hazrat-e-Zeinab hospital in 2014. The eligible infants were randomly divided into two intervention groups and a control group using permuted block randomization. In 24 hours, the infants in the first intervention group were placed in prone position every 2 hours and in other positions for an hour and the process continued. In addition to prone positioning, the second intervention group received chest physiotherapy every 8 hours. Each hour, vital signs and oxygen saturation were recorded according to the order recorded in Arterial Blood Gas (ABG) records. The results and changes in ventilation were recorded, as well. After all, the data were entered into the SPSS statistical software, version 16 and were analyzed using the indices of descriptive statistics (mean and standard deviation), ANOVA, paired T-test, and post-hoc test.Results: The mean duration of intubation in prone positioning along with chest physiotherapy, prone positioning alone, and control groups was 3.22±0.95, 5.78±2.32, and 6.83+1.43 days, respectively (P<0.001). Besides, the rate of re-intubation in prone positioning along with chest physiotherapy, prone positioning alone, and control groups was 8%, 17%, and 52%, respectively (P=0.002). Durations of intubation and re-intubation were significantly lower in prone positioning along with chest physiotherapy compared to prone positioning alone.Conclusion: According to the findings of this study and the lower duration of intubation while prone positioning with chest physiotherapy, medical staff working in NICUs can use these two methods in taking care of premature infants to accelerate their separation process from the ventilator.

Keywords:

Premature infant , Prone positioning , Chest physiotherapy , Intubation