"Positioning may reduce the need for such interventions, or at least reduce the length of time they are required, thereby reducing the associated risk of longer-term lung damage," Wells says.
Some physicians recommend a stomach position to adult patients with acute respiratory problems as a noninvasive way to increase their oxygen levels. But since stomach sleeping is associated with SIDS, Wells and colleagues decided the benefits of stomach positioning should be evaluated specifically in children.
Nurses in Wells' hospital and others had also noticed that babies six to 18 months who were in respiratory distress "would not lie down to sleep, but would fall asleep when upright over someone's shoulder," Wells says.
If they did manage to lie down, the babies would roll onto their stomachs and flex their hips and knees up like a frog, she adds. The babies' behavior led the nurses to wonder if the infants were trying to relieve their breathing problems by wriggling into a position that allowed them to take in more oxygen.
Wells and colleagues reviewed findings from 21 studies of infants and children with acute respiratory distress that compared the benefits of a variety of different positions, including stomach, back and side-lying positions and elevated head and sitting positions. The studies included 436 patients, 74 percent of whom were premature infants. About 70 percent of the premature infants were breathing with the help of a mechanical ventilator.
While there is no official definition of acute respiratory distress, according to Wells, the children included in the study were hospitalized with severe breathing problems stemming from a variety of causes, from congenital lung problems to upper respiratory infections.
There were not enough data among the studies to determine whether any of the other s
'"/>
Contact: Deborah Wells
DeboraW2@chw.edu.au
Center for the Advancement of Health
19-Apr-2005