Positioning for acute respiratory distress in hospitalised infants and children.
Identifieur interne : 000429 ( Main/Exploration ); précédent : 000428; suivant : 000430Positioning for acute respiratory distress in hospitalised infants and children.
Auteurs : D A Wells [Australie] ; D. Gillies ; D A FitzgeraldSource :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2005.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Dysplasie bronchopulmonaire (thérapie), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Essais contrôlés randomisés comme sujet (MeSH), Humains (MeSH), Infections de l'appareil respiratoire (thérapie), Insuffisance respiratoire (thérapie), Nourrisson (MeSH), Nouveau-né (MeSH), Posture (MeSH), Prématuré (MeSH), Résultat thérapeutique (MeSH), Syndrome de détresse respiratoire de l'adulte (thérapie), Syndrome de détresse respiratoire du nouveau-né (thérapie).
- MESH :
- thérapie : Dysplasie bronchopulmonaire, Infections de l'appareil respiratoire, Insuffisance respiratoire, Syndrome de détresse respiratoire de l'adulte, Syndrome de détresse respiratoire du nouveau-né.
- Adolescent, Enfant, Enfant d'âge préscolaire, Essais contrôlés randomisés comme sujet, Humains, Nourrisson, Nouveau-né, Posture, Prématuré, Résultat thérapeutique.
English descriptors
- KwdEn :
- Adolescent (MeSH), Bronchopulmonary Dysplasia (therapy), Child (MeSH), Child, Preschool (MeSH), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Infant, Premature (MeSH), Posture (MeSH), Randomized Controlled Trials as Topic (MeSH), Respiratory Distress Syndrome, Adult (therapy), Respiratory Distress Syndrome, Newborn (therapy), Respiratory Insufficiency (therapy), Respiratory Tract Infections (therapy), Treatment Outcome (MeSH).
- MESH :
- therapy : Bronchopulmonary Dysplasia, Respiratory Distress Syndrome, Adult, Respiratory Distress Syndrome, Newborn, Respiratory Insufficiency, Respiratory Tract Infections.
- Adolescent, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Infant, Premature, Posture, Randomized Controlled Trials as Topic, Treatment Outcome.
Abstract
BACKGROUND
Because of the association between prone positioning and sudden infant death syndrome SIDS) it is recommended that young infants be placed on their backs (supine). However, the supine position might not be the most appropriate position for infants and children hospitalised with acute respiratory distress. Positioning patients has been proposed as a non-invasive way of increasing oxygenation in adult patients with acute respiratory distress. But, because of substantial differences in respiratory mechanics between adults and children and the risk of SIDS in young infants, a specific review of positioning for infants and young children with acute respiratory distress is warranted.
OBJECTIVES
To compare the effects of different body positions in hospitalised infants and children with acute respiratory distress.
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2004); MEDLINE (January 1966 to October Week 3, 2004); EMBASE (1980 to week 24, 2004); and CINAHL (1982 to October Week 3, 2004).
SELECTION CRITERIA
All randomised or systematically-allocated controlled clinical trials comparing two or more positions in the management of infants and children hospitalised with acute respiratory distress.
DATA COLLECTION AND ANALYSIS
Data were extracted from each study independently by two authors. Differences were resolved by consensus or referral to a third author. Continuous outcomes were analysed using a weighted mean difference and 95% confidence interval. No bivariate outcomes were available. All but one included study reported crossover data therefore this data was used for meta-analysis. Fixed-effect models were used unless heterogeneity was significant (p value equal to or less than 0.1), in which case a random-effects model was used.
MAIN RESULTS
Forty-nine papers were selected for this review of which 21 studies (22 publications) were included. These studies compared prone, supine, lateral, elevated, and flat positions. Prone positioning was significantly more beneficial than supine positioning in terms of oxygen saturation, partial pressure of arterial oxygen, oxygenation index, thoraco-abdominal synchrony, and episodes of desaturation. There were no statistically significant differences between any other positions.
AUTHORS' CONCLUSIONS
The prone position was significantly superior to the supine position in terms of oxygenation. However, as most patients included in the meta-analysis were ventilated, preterm infants the benefits of prone positioning may be most relevant to these infants. In addition, although placing infants and children in the prone position may improve respiratory function, the association of sudden infant death with prone positioning means that infants should only be placed in this position if continuous cardiorespiratory monitoring is used.
DOI: 10.1002/14651858.CD003645.pub2
PubMed: 15846674
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Gillies</name></author><author><name sortKey="Fitzgerald, D A" sort="Fitzgerald, D A" uniqKey="Fitzgerald D" first="D A" last="Fitzgerald">D A Fitzgerald</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2005">2005</date><idno type="RBID">pubmed:15846674</idno><idno type="pmid">15846674</idno><idno type="doi">10.1002/14651858.CD003645.pub2</idno><idno type="wicri:Area/Main/Corpus">000423</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000423</idno><idno type="wicri:Area/Main/Curation">000423</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000423</idno><idno type="wicri:Area/Main/Exploration">000423</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Positioning for acute respiratory distress in hospitalised infants and children.</title><author><name sortKey="Wells, D A" sort="Wells, D A" uniqKey="Wells D" first="D A" last="Wells">D A Wells</name><affiliation wicri:level="1"><nlm:affiliation>Nursing Department, Children's Hospital at Westmead, Locked Bag 4001, Hawkesbury and Hainsworth St, Westmead, NSW, Australia, 2145. DeboraW2@chw.edu.au</nlm:affiliation><country wicri:rule="url">Australie</country></affiliation></author><author><name sortKey="Gillies, D" sort="Gillies, D" uniqKey="Gillies D" first="D" last="Gillies">D. Gillies</name></author><author><name sortKey="Fitzgerald, D A" sort="Fitzgerald, D A" uniqKey="Fitzgerald D" first="D A" last="Fitzgerald">D A Fitzgerald</name></author></analytic><series><title level="j">The Cochrane database of systematic reviews</title><idno type="eISSN">1469-493X</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Bronchopulmonary Dysplasia (therapy)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Infant, Newborn (MeSH)</term><term>Infant, Premature (MeSH)</term><term>Posture (MeSH)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Respiratory Distress Syndrome, Newborn (therapy)</term><term>Respiratory Insufficiency (therapy)</term><term>Respiratory Tract Infections (therapy)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Dysplasie bronchopulmonaire (thérapie)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Infections de l'appareil respiratoire (thérapie)</term><term>Insuffisance respiratoire (thérapie)</term><term>Nourrisson (MeSH)</term><term>Nouveau-né (MeSH)</term><term>Posture (MeSH)</term><term>Prématuré (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Syndrome de détresse respiratoire du nouveau-né (thérapie)</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Bronchopulmonary Dysplasia</term><term>Respiratory Distress Syndrome, Adult</term><term>Respiratory Distress Syndrome, Newborn</term><term>Respiratory Insufficiency</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Dysplasie bronchopulmonaire</term><term>Infections de l'appareil respiratoire</term><term>Insuffisance respiratoire</term><term>Syndrome de détresse respiratoire de l'adulte</term><term>Syndrome de détresse respiratoire du nouveau-né</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Infant, Premature</term><term>Posture</term><term>Randomized Controlled Trials as Topic</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Nourrisson</term><term>Nouveau-né</term><term>Posture</term><term>Prématuré</term><term>Résultat thérapeutique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Because of the association between prone positioning and sudden infant death syndrome SIDS) it is recommended that young infants be placed on their backs (supine). However, the supine position might not be the most appropriate position for infants and children hospitalised with acute respiratory distress. Positioning patients has been proposed as a non-invasive way of increasing oxygenation in adult patients with acute respiratory distress. But, because of substantial differences in respiratory mechanics between adults and children and the risk of SIDS in young infants, a specific review of positioning for infants and young children with acute respiratory distress is warranted.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To compare the effects of different body positions in hospitalised infants and children with acute respiratory distress.</p></div><div type="abstract" xml:lang="en"><p><b>SEARCH STRATEGY</b></p><p>We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2004); MEDLINE (January 1966 to October Week 3, 2004); EMBASE (1980 to week 24, 2004); and CINAHL (1982 to October Week 3, 2004).</p></div><div type="abstract" xml:lang="en"><p><b>SELECTION CRITERIA</b></p><p>All randomised or systematically-allocated controlled clinical trials comparing two or more positions in the management of infants and children hospitalised with acute respiratory distress.</p></div><div type="abstract" xml:lang="en"><p><b>DATA COLLECTION AND ANALYSIS</b></p><p>Data were extracted from each study independently by two authors. Differences were resolved by consensus or referral to a third author. Continuous outcomes were analysed using a weighted mean difference and 95% confidence interval. No bivariate outcomes were available. All but one included study reported crossover data therefore this data was used for meta-analysis. Fixed-effect models were used unless heterogeneity was significant (p value equal to or less than 0.1), in which case a random-effects model was used.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN RESULTS</b></p><p>Forty-nine papers were selected for this review of which 21 studies (22 publications) were included. These studies compared prone, supine, lateral, elevated, and flat positions. Prone positioning was significantly more beneficial than supine positioning in terms of oxygen saturation, partial pressure of arterial oxygen, oxygenation index, thoraco-abdominal synchrony, and episodes of desaturation. There were no statistically significant differences between any other positions.</p></div><div type="abstract" xml:lang="en"><p><b>AUTHORS' CONCLUSIONS</b></p><p>The prone position was significantly superior to the supine position in terms of oxygenation. However, as most patients included in the meta-analysis were ventilated, preterm infants the benefits of prone positioning may be most relevant to these infants. In addition, although placing infants and children in the prone position may improve respiratory function, the association of sudden infant death with prone positioning means that infants should only be placed in this position if continuous cardiorespiratory monitoring is used.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">15846674</PMID><DateCompleted><Year>2005</Year><Month>07</Month><Day>19</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>21</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1469-493X</ISSN><JournalIssue CitedMedium="Internet"><Issue>2</Issue><PubDate><Year>2005</Year><Month>Apr</Month><Day>18</Day></PubDate></JournalIssue><Title>The Cochrane database of systematic reviews</Title></Journal><ArticleTitle>Positioning for acute respiratory distress in hospitalised infants and children.</ArticleTitle><Pagination><MedlinePgn>CD003645</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Because of the association between prone positioning and sudden infant death syndrome SIDS) it is recommended that young infants be placed on their backs (supine). However, the supine position might not be the most appropriate position for infants and children hospitalised with acute respiratory distress. Positioning patients has been proposed as a non-invasive way of increasing oxygenation in adult patients with acute respiratory distress. But, because of substantial differences in respiratory mechanics between adults and children and the risk of SIDS in young infants, a specific review of positioning for infants and young children with acute respiratory distress is warranted.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To compare the effects of different body positions in hospitalised infants and children with acute respiratory distress.</AbstractText><AbstractText Label="SEARCH STRATEGY" NlmCategory="METHODS">We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2004); MEDLINE (January 1966 to October Week 3, 2004); EMBASE (1980 to week 24, 2004); and CINAHL (1982 to October Week 3, 2004).</AbstractText><AbstractText Label="SELECTION CRITERIA" NlmCategory="METHODS">All randomised or systematically-allocated controlled clinical trials comparing two or more positions in the management of infants and children hospitalised with acute respiratory distress.</AbstractText><AbstractText Label="DATA COLLECTION AND ANALYSIS" NlmCategory="METHODS">Data were extracted from each study independently by two authors. Differences were resolved by consensus or referral to a third author. Continuous outcomes were analysed using a weighted mean difference and 95% confidence interval. No bivariate outcomes were available. All but one included study reported crossover data therefore this data was used for meta-analysis. Fixed-effect models were used unless heterogeneity was significant (p value equal to or less than 0.1), in which case a random-effects model was used.</AbstractText><AbstractText Label="MAIN RESULTS" NlmCategory="RESULTS">Forty-nine papers were selected for this review of which 21 studies (22 publications) were included. These studies compared prone, supine, lateral, elevated, and flat positions. Prone positioning was significantly more beneficial than supine positioning in terms of oxygen saturation, partial pressure of arterial oxygen, oxygenation index, thoraco-abdominal synchrony, and episodes of desaturation. There were no statistically significant differences between any other positions.</AbstractText><AbstractText Label="AUTHORS' CONCLUSIONS" NlmCategory="CONCLUSIONS">The prone position was significantly superior to the supine position in terms of oxygenation. However, as most patients included in the meta-analysis were ventilated, preterm infants the benefits of prone positioning may be most relevant to these infants. In addition, although placing infants and children in the prone position may improve respiratory function, the association of sudden infant death with prone positioning means that infants should only be placed in this position if continuous cardiorespiratory monitoring is used.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wells</LastName><ForeName>D A</ForeName><Initials>DA</Initials><AffiliationInfo><Affiliation>Nursing Department, Children's Hospital at Westmead, Locked Bag 4001, Hawkesbury and Hainsworth St, Westmead, NSW, Australia, 2145. DeboraW2@chw.edu.au</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gillies</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Fitzgerald</LastName><ForeName>D A</ForeName><Initials>DA</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D016454">Review</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2005</Year><Month>04</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Cochrane Database Syst Rev</MedlineTA><NlmUniqueID>100909747</NlmUniqueID><ISSNLinking>1361-6137</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="UpdateIn"><RefSource>Cochrane Database Syst Rev. 2012;7:CD003645</RefSource><PMID Version="1">22786486</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001997" MajorTopicYN="N">Bronchopulmonary Dysplasia</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007234" MajorTopicYN="N">Infant, Premature</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011187" MajorTopicYN="Y">Posture</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012127" MajorTopicYN="N">Respiratory Distress Syndrome, Newborn</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012131" MajorTopicYN="N">Respiratory Insufficiency</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>81</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2005</Year><Month>4</Month><Day>23</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2005</Year><Month>7</Month><Day>20</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2005</Year><Month>4</Month><Day>23</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">15846674</ArticleId><ArticleId IdType="doi">10.1002/14651858.CD003645.pub2</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li></country></list><tree><noCountry><name sortKey="Fitzgerald, D A" sort="Fitzgerald, D A" uniqKey="Fitzgerald D" first="D A" last="Fitzgerald">D A Fitzgerald</name><name sortKey="Gillies, D" sort="Gillies, D" uniqKey="Gillies D" first="D" last="Gillies">D. Gillies</name></noCountry><country name="Australie"><noRegion><name sortKey="Wells, D A" sort="Wells, D A" uniqKey="Wells D" first="D A" last="Wells">D A Wells</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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