The prone position is associated with a decrease in respiratory system compliance in healthy anaesthetized infants

• Published in: Pediatric anesthesia Vol. 11; no. 3; pp. 291 - 296
• Main Authors: Cox, Robin G., Ewen, Alastair, Bart, Bevin B.
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01.05.2001; Blackwell
• Subjects: Anesthesia; Anesthesia, General; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Hemodynamics - physiology; Humans; Infant; infant anaesthesia; Lung Compliance - physiology; Male; Medical sciences; Prone Position - physiology; prone positioning; Pulmonary Gas Exchange - physiology; Respiratory Mechanics - physiology; respiratory system compliance; Supine Position - physiology; Human; Lung function; Mechanic of breathing; General anesthesia; Infant; Dorsal decubitus; Patient position; Respiratory system; Compliance(volume pressure); Ventral decubitus; Comparative study
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1046/j.1460-9592.2001.00646.x

Ten healthy (ASA I or II) anaesthetized infants undergoing clubfoot surgery were studied. General anaesthesia included rocuronium, nitrous oxide and isoflurane. Volume controlled ventilation (12 ml·kg−1) was delivered via a coaxial Mapleson‐D (Bain) system and a Datex AS/3 ventilator. Pulmonary mechanics were measured sequentially in the supine and prone positions using a Bicore CP‐100 pulmonary function monitor. Subjects had a mean age of 6 (± 2) months and a mean weight of 8.3 (± 1.4) kg. Dynamic compliance (CDYN) and static compliance (CSTAT) were both significantly lower in the prone position than in the supine position (P < 0.0005). Mean CDYN decreased from 14.9 ± 4.9 ml·cmH2O–1 (supine) to 11.6 ± 3.5 ml·cmH2O–1 (prone). Mean CSTAT decreased from 10.2 ± 2.8 ml·cmH2O–1 (supine) to 8.9 ± 2.3 ml·cmH2O–1 (prone). No clinically significant differences in gas exchange were noted, however, on repositioning.